Immunomodulating compounds and related compositions and methods

ABSTRACT

Provided herein are compounds, compositions and methods for balancing a T-helper cell profile and in particular Th1, Th2, Th17 and Treg cell profiles, and related methods and compositions for treating or preventing an inflammatory condition associated with an imbalance of a T-helper cell profile.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.12/831,131, filed on Jul. 6, 2010, which, in turn, claims priority toU.S. Provisional Application Ser. No. 61/223,294, entitled “PSA fromBacteroides Fragilis Cures Established Colitis” and filed on Jul. 6,2009, and U.S. Provisional Application Ser. No. 61/355,025, entitled“PSA from Bacteroides Fragilis Cures Established Colitis” and filed onJun. 15, 2010, the disclosure of all of which are incorporated byreference in their entirety. U.S. patent application Ser. No. 12/831,131is also a continuation in part of U.S. patent application Ser. No.12/267,602, entitled Immunomodulating Compounds and Related Compositionsand Methods” and filed on Nov. 9, 2008, which, in turn, claims priorityto U.S. Provisional Application No. 61/002,705, entitled “Host-BacterialMutualism by a Microbial Symbiosis Factor Prevents Inflammatory Disease”and filed on Nov. 9, 2007 (Docket No. CIT 5031-P), U.S. ProvisionalApplication No. 61/008,407, entitled “Host-Bacterial Mutualism by aMicrobial Symbiosis Factor Prevents Inflammatory Disease” and filed onDec. 20, 2007 (Docket No. CIT 5031-P2) and U.S. Provisional ApplicationNo. 61/196,046, entitled “A Molecule from a Symbiotic Gut BacteriaControls Systemic Inflammation” and filed on Oct. 14, 2008 (Docket No.CIT 5250-P), the disclosure of all of which are incorporated herein byreference in its entirety.

STATEMENT OF GOVERNMENT GRANT

The U.S. Government has certain rights in this invention pursuant toGrant No. A1039576 and grant No. DK078938 awarded by the NationalInstitutes of Health.

FIELD

The present disclosure relates to the immune system, and, in particular,to an immunomodulating compound able to control T cell differentiationand/or cytokines production associated with an immunitary response in anindividual.

BACKGROUND

T cells belong to a group of white blood cells known as lymphocytes, andplay a central role in cell-mediated immunity. In particular, T helpercells (also known as effector T cells or Th cells) are a sub-group oflymphocytes (a type of white blood cell or leukocyte) that plays animportant role in establishing and maximizing the capabilities of theimmune system and in particular in activating and directing other immunecells. More particularly, Th cells are essential in determining B cellantibody class switching, in the activation and growth of cytotoxic Tcells, and in maximizing bactericidal activity of phagocytes such asmacrophages.

Different types of Th cells have been identified that originate inoutcome of a differentiation process and are associated with a specificphenotype. Following T cell development, matured, naïve (meaning theyhave never been exposed to the antigen to which they can respond) Tcells leave the thymus and begin to spread throughout the body. Once thenaïve T cells encounter antigens throughout the body, they candifferentiate into a T-helper 1 (Th1), T-helper 2(Th2), T-helper 17(Th17) or regulatory T cell (Treg) phenotype.

Each of these Th cell types secretes cytokines, proteins or peptidesthat stimulate or interact with other leukocytes, including T_(h) cells.However, each cell type has a peculiar phenotype and activity thatinterferes and often conflict with the other.

Th1, Th2, and Th17 (inflammatory T-helper or inflammatory Th), promoteinflammation responses trough secretion of pro-inflammatory cytokines,such as IL-1, IL-6, TNF-a, IL-17, IL21, IL23, and/or through activationand/or inhibition of other T cell including other Th cells (for exampleTh1 cell suppresses Th2 and Th17, Th2 suppresses Th1 and Th17). Tregsinstead, are a component of the immune system that suppresses biologicalactivities of other cells associated to an immune response. Inparticular, Tregs can secrete immunosuppressive cytokines TGF-beta andInterleukin 10, and are known to be able to limit or suppressinflammation.

An imbalance in the profile of any of the inflammatory T-helper cells isusually associated with a condition in an individual. For example, anincrease profile for Th1 or Th17 leads to autoimmunity, whereas anincreased Th2 cell profile leads to allergies and asthma. In particular,imbalance of Th17 cell profile has been associated with severalautoimmunitary conditions. Treg cells suppress inflammation induced byall 3 other T cell lineages, and thus are crucial for preventinguncontrolled inflammation, which leads to disease. Therefore, a balancedT-helper profile is critical for health in individuals.

SUMMARY

Provided herein, are immunomodulating compounds and related methods andcompositions that are suitable to balance a T-helper cell profile, andin particular to balance the cell profile of at least one of Th1, Th2,Th17 and Treg cells in an individual. More particularly, provided hereinare methods and compositions based on the surprising immunomodulatingproperties of PSA polysaccharide A (PSA) and other zwitterionicpolysaccharides (ZPs) that make those polysaccharides suitable fortreatment, prevention and control of inflammations and inflammatoryconditions in an individual.

According to a first aspect, a method to balance a T-helper cell profilein an individual is disclosed. The method comprises administering to theindividual an effective amount of a zwitterionic polysaccharide.

According to a second aspect, a method to balance a cell profile of atleast one Th cell selected from the group consisting of Th1, Th2, Th17and Treg, in an individual is disclosed. The method comprisesadministering to the individual an effective amount of a zwitterionicpolysaccharide.

According to a third aspect, a method to control cytokine production inan individual, is disclosed, the cytokine being at least one of IL-1,IL-6, TNF-a, IL-17, IL21, IL23. The method comprises administering tothe individual an effective amount of a zwitterionic polysaccharide.

According to a fourth aspect, a method to control inflammationassociated with a Th-cell profile imbalance in an individual isdisclosed. The method comprises administering to the individual aneffective amount of a zwitterionic polysaccharide.

According to a fifth aspect, a method to treat or prevent conditionsassociated with an imbalanced cell profile of at least one Th cellselected from the group consisting of Th1, Th2, Th17 and Treg in anindividual is disclosed. The method comprises administering to theindividual an effective amount of a zwitterionic polysaccharide.

According to a sixth aspect, a method to treat or prevent conditionsassociated with production of at least one of IL-1, IL-6, TNF-a, IL-17,IL21, IL23 cytokines in an individual, is disclosed. The methodcomprises administering to the individual an effective amount of azwitterionic polysaccharide.

According to a seventh aspect, an anti-inflammatory composition isdisclosed. The anti-inflammatory composition comprises a zwitterionicpolysaccharide and a suitable vehicle, wherein the zwitterionicpolysaccharide is comprised in an amount of from about 1 to about 100μg.

The compositions and methods herein disclosed can be used in severalembodiments to simultaneously control and balance the profile of Th1,Th2, Th17 and Treg cells in an individual, thus preventing or treatingconditions associated with an imbalanced profile for those cytokines inthe individual.

The compositions and methods herein described can be used in connectionwith medical, pharmaceutical, veterinary applications as well asfundamental biological studies and various applications, identifiable bya skilled person upon reading of the present disclosure, whereininvestigating the possible role of a zwitterionic polysaccharide isdesirable.

The details of one or more embodiments of the disclosure are set forthin the accompanying drawings and the description below. Other features,objects, and advantages will be apparent from the description anddrawings, and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated into and constitute apart of this specification, illustrate one or more embodiments of thepresent disclosure and, together with the detailed description, serve toexplain the principles and implementations of the disclosure.

FIG. 1 shows an exemplary ZP mediated protection from experimentalcolitis in individuals according to some embodiments herein disclosed.Panel (a) shows diagrams summarizing the results of mono-association ofgerm-free mice with wild-type B. fragilis and B. fragilis DPSA (meanpercentages±Standard Deviation (SD) for 3 experiments: conventional,38.4%±2.2; germ-free, 26.7%±1.3; B. fragilis, 40.8%±3.1; B. fragilisDPSA, 28.8%±2.6). All cells gated on CD4⁺ splenocytes. Panel (b) shows adiagram illustrating the results of co-colonization experiments of H.hepaticus with B. fragilis and B. fragilis DPSA (two-tailed p value,0.004; Mann-Whitney U test). Combined data from 2 independentexperiments are shown. Error bars show SD for triplicate samples. Panel(c) shows a diagram illustrating the results of ELISA test of colonorgan cultures to detect TNFa levels in animals co-colonized with H.hepaticus and wild-type B. fragilis or B. fragilis DPSA. Panel (d) showsa diagram illustrating the results of a Q-PCR for IL-23p19 performed onsplenocytes, normalized to L32 expression. Error bars show SD fortriplicate samples.

FIG. 2 shows an exemplary ZP mediated cytokine control according to someembodiments herein disclosed. In particular, FIG. 2 shows diagramsillustrating the results of ELISA tests for the detection of thepro-inflammatory cytokines IL-12p40 (left) and IL-1b (right) in animalsco-colonized with H. hepaticus and wild-type B. fragilis or B. fragilisDPSA over those in control animals (C57BL/6). Results are from one trialof 2 independent experiments. Error bars indicate SD values from studiesof colons recovered from 4 animals per group.

FIG. 3 shows an example of ZP mediated control of TNFa expression byCD4⁺ T cells according to some embodiments herein disclosed. Inparticular FIG. 3 CD4⁺ cells were purified from pooled splenocytes fromeach group (4 mice per group) and restimulated in vitro with PMA andionomycin in the presence of brefeldin A for 4 hours. Cells were stainedfor intracellular TNFα. Cells within the lymphocyte gate were includedin the analysis, and numbers indicate the percentage of cells producingTNFα. Purified cells were >90% CD4⁺. Animals colonized withPSA-producing B. fragilis during protection displayed lower TNFa levelsthan diseased animals.

FIG. 4 shows control experiments supporting various embodiments hereindescribed. Panel (a) shows an ethidium bromide-stained gelelectrophoresis of H. hepaticus-specific Q-PCR performed followingco-colonization with wild-type and various mutants of B. fragilis after8 weeks. M: Marker. 1: Rag2^(−/−) animals with CD4⁺CD45Rb^(high) T celltransfer colonized with H. hepaticus alone. 2: Rag2^(−/−) animals withCD4⁺CD45Rb^(high) T cell transfer colonized with H. hepaticus and B.fragilis 9343 (wt). 3: Rag2^(−/−) animals with CD4⁺CD45Rb^(high) T celltransfer colonized with H. hepaticus and B. fragilis DPSA. 4: C57BL/6mice colonized with H. hepaticus alone. Note: H. hepaticus readilycolonized animals but did not induce disease (FIG. 1). Primers for H.hepaticus 16S rDNA: (HB-15) 5′-GAAACTGTTACTCTG-3′ (SEQ ID NO: 1) and(HB-17) 5′-TCAAGCTCCCCGAAGGG-3′ (SEQ ID NO: 2). Panel (b) shows ethidiumbromide-stained gel electrophoresis of B. fragilis-specific Q-PCRperformed following co-colonization with wild-type and various mutantsof B. fragilis after 8 weeks. A: Rag2^(−/−) animals withCD4⁺CD45Rb^(high) T cell transfer colonized with H. hepaticus and B.fragilis 9343 (wt). B: Rag2^(−/−) animals with CD4⁺CD45Rb^(high) T celltransfer colonized with H. hepaticus and B. fragilis DPSA. C: Rag2^(−/−)animals with CD4⁺CD45Rb^(high) T cell transfer colonized with H.hepaticus alone. D: C57BL/6 mice colonized with H. hepaticus alone. E:B. fragilis genomic DNA (positive control). M: Marker. Primers for B.fragilis ssr3 (finB) gene: (ssr3-F) 5′-TATTTGCGAGAAGGTGAT-3′ (SEQ ID NO:3) and (ssr3-r) 5′-TAAACGCTTTGCTGCTAT-3′(SEQ ID NO: 4).

FIG. 5 effects associated to a ZP-mediated protection according to someembodiments herein disclosed. In particular, FIG. 5 shows a diagramillustrating the results of Q-PCR experiments directed to quantitate H.hepaticus in animals co-colonized with H. hepaticus and wild-type B.fragilis or B. fragilis DPSA. The results was assessed according toYoung et al., 2004 ¹ as log¹⁰ number of copies of a known gene(cytolethal distending toxin). Animals contained equivalent levels of H.hepaticus at the end of the experiment.

FIG. 6 shows a ZPs mediated protection according to some embodimentsherein disclosed. Panel (a) shows a diagram illustrating the results ofa colonization with H. hepaticus in absence (second column) or inpresence of purified PSA (third column) (Kruskal-Wallis comparisons ofall groups:p>0.05 for dissimilar results, p<0.01 for similar results;Mann-Whitney U test: two-tailed p value, 0.0002). Panel (b) shows adiagram illustrating results of experiments directed to detect wastingdisease in Rag2^(−/−) animals following transfer of CD4⁺CD45Rb^(high) Tcells and colonization with H. hepaticus (PBS+Hh) in presence or absenceof PSA as indicated. ANOVA indicates that comparisons between allindicated groups (asterisks) are statistically significant. Panel (c)shows the architecture of colonic sections from wild-type animals (leftpanel); following transfer of CD4⁺CD45Rb ^(high) T cell intoHelicobacter-colonized Rag2^(−/−) mice (middle panel); oral PSAtreatment of Helicobacter-colonized animals (right panel). Images ineach row are the same magnification.

FIG. 7 shows a ZP modulated immune response according to someembodiments herein disclosed. Panel (a) shows a diagram illustrating thecorrelation between oral PSA administration and body weight related toTNBS-treated PBS controls. ANOVA values for all indicated groups(asterisks) are statistically significant. Error bars show SD between 4animals per group. Panel (b) shows colon sections from TNBS+PBS-treatedgroups, from TNBS+PSA-treated animals and from a control (representativesections from animals in 2 independent experiments). Panels (c, d) showdiagram illustrating the results of Q-PCR of purified CD4⁺ T cells fromMLNs with IL-17A (Panel c) and TNFa (Panel d) in presence or absence ofPSA during disease. Error bars are from duplicate runs of 3 independentexperiments. Panels (e, f) show diagrams illustrating transcriptionalexpression of IL17A (Panel e) and TNFα (Panel f) from homogenized colonsof TNBS+PBS-treated groups, from TNBS+PSA-treated animals and from acontrol. Error bars are from duplicate runs of 3 independentexperiments.

FIG. 8 shows a ZP mediated control of cytokine expression according tosome embodiments herein disclosed. Panel (a) shows a diagramillustrating the results of Q-PCR assay of colons for IL-10 in wild typemice treated with ethanol (control), TNBS, or TNBS and PSA. Error barsshow SD for triplicate samples. Panel (b) shows a diagram illustratingQ-PCR results for IL-10 expression in CD4⁺ T cells purified from MLNs ofTNBS-treated groups. Error bars show SD for triplicate samples. Panel(c) shows a diagram illustrating the effects of incubation of BMDC/Tcell co-cultures with purified PSA LPS and a-CD3/a-CD28 on IL-10production. Error bars show SD for triplicate samples. Panel (d) shows adiagram illustrating the results of an infection of BMDC-T cellco-cultures with increasing concentrations of H. hepaticus (multiplicityof infection: 0.1, 1.0, and 10, as depicted by triangles) on TNFarelease in presence (middle three bars) or absence (left three bars) ofPSA and following the addition of aIL-10R right three bars □. Error barsshow SD values of experiments run in triplicate.

FIG. 9 shows a ZP mediated control of cytokine expression according tosome embodiments herein disclosed. In particular, FIG. 9 shows a diagramillustrating the results for an IL-10 ELISA of supernatants of primaryBMDC-T cell co-cultures incubated for 48 hours with H. hepaticus aloneor with H. hepaticus and B. fragilis (wild-type or ΔPSA) at amultiplicity of infection of 5. Error bars show SD values for samplesrun in duplicate and represent 3 independent experiments.

FIG. 10 shows a ZP mediated control of cytokine expression according tosome embodiments herein disclosed. In particular, FIG. 10 shows adiagram illustrating the results of an infection of BMDC-T cellco-cultures with increasing concentrations of live H. hepaticus(multiplicity of infection: 0.1, 1.0, and 10, as depicted by triangles)on release of the cytokine IL-1b in presence (middle three bars) orabsence (left three bars) of PSA and following the addition of aIL-10Rright three bars. Error bars show SD values for experiments run intriplicate.

FIG. 11 shows a ZP mediated protection from inflammation according tosome embodiments herein disclosed. Panels (a, b) show diagramsillustrating results of ELISA detection for pro-inflammatory cytokinesTNFα (Panel a) and IL-17A (Panel b) in IL-10^(−/−) mice left uncolonized(control) or colonized with H. hepaticus (to induce inflammation) eitheralone or in combination with B. fragilis (wild-type or ΔPSA). Error barsshow SD for triplicate samples. Panel (c) shows a diagram illustratingthe colitis scores in Rag^(−/−) animals with CD4⁺CD45Rb^(high) T celltransfer colonized with H. hepaticus with or without PSA and in presenceof neutralizing antibodies to IL-10 block (α-IL10R). Data represent 2independent experiments. Panel (d) shows a diagram illustrating colitisscores in Rag^(−/−) animals with CD4⁺CD45Rb^(high) T cell transferredfrom IL-10^(−/−) mice colonized with H. hepaticus with PSA or PBS.Results are shown for 1 representative trial of 2 independentexperiments. Panel (e) shows histologic colon sections Rag⁻⁻ animalswith CD4⁺CD45Rb^(high) T cell transferred from IL-10^(−/−) micecolonized with H. hepaticus with PSA or PBS. All images are the samemagnification. Panel (f) shows a diagram illustrating the mean bodyweights for groups of Rag^(−/−) animals (n=4) with CD4⁺CD45Rb^(high) Tcell transferred from IL-10 ^(−/−) mice colonized with H. hepaticus withPSA or PBS.

FIG. 12 shows effect of a ZP administration supporting embodimentsherein disclosed. In particular, FIG. 12 shows a diagram illustratingthe variation on body weight in groups of 4 C57BL/6 mice treated withPSA (or PBS) and then subjected to rectal administration of TNBS orvehicle (control). Mean body weights (shown as percentages of initialweight) are shown for each group; SD values indicate that, in theabsence of IL-10, PSA cannot restore TNBS-induced weight loss. ANOVAdemonstrates that weight loss in both TNBS-treated groups isstatistically different from that in control animals.

FIG. 13 shows effects of a ZP administration supporting some embodimentsherein disclosed. In particular, FIG. 13 shows results of histologicanalysis of H&E-stained sections from a representative animal of groupsof 4 C57BL/6 mice treated with PSA (or PBS) and then subjected to rectaladministration of TNBS or vehicle (control). Results represent 2independent experiments.

FIG. 14 shows inhibition of inflammation within extra-intestinal immunecompartments following oral administration of ZPS according to someembodiments herein disclosed. In particular, Panel (a) shows a diagramillustrating the colonic histological score detected in untreated mice(control) and in mice treated with TNBS or TNBS/PSA. Each dot representsan individual mouse and the line indicates the average score of thegroup. Panel (b) shows a diagram illustrating the percent of survival intime of Balb/c mice undergoing TNBS induced colitis. n=16 mice in eachgroup. Panel (c) shows an image of the spleen of untreated mice(control) and mice treated with TNBS or TNBS/PSA Panel (d) shows adiagram illustrating the relative units of TNF-α, IL-6, IL-17A and IL-10within CD4+ splenocytes in untreated mice (control) and in mice treatedwith TNBS or TNBS/PSA. These data are representative of threeindependent experiments.

FIG. 15 shows protection from TNBS induced intestinal colitis followingadministration of ZPS to extra-intestinal sites according to someembodiments herein disclosed. In particular, Panel (a) shows a diagramillustrating the percent survival of mice undergoing TNBS inducedcolitis. n=10 mice in each group. Panel (b) shows a diagram illustratingvariation of the spleen weight in untreated mice (Etoh) and in micetreated with TNBS or TNBS/PSA systemically administered. The weight ofthe spleen was used as an indicator of size. Each diamond represents theweight of the spleen from an individual animal. The bar indicates theaverage weight of the group. P values were determined by students Ttest.

FIG. 16 shows inhibition of inflammatory cytokines at both intestinaland systemic immune compartments following systemic administration ofZPS during TNBS induced colitis according to some embodiments hereindisclosed. Panel (a) shows a diagram illustrating TNF-α production inCD4+ T lymphocytes residing within the mesenteric lymph nodes (MLN)splenocytes in untreated mice (control) and in mice treated with TNBS orTNBS/PSA. Cells were collected from the MLN and stained with antibodiesrecognizing CD4 or TNF-a. Numbers within quadrants represent thepercentage of cells. Panel (b) shows a diagram illustrating analysis ofthe expression of IL-12, IL-23, and IL-17 in colon of untreated mice(control) and mice treated with TNBS or TNBS/PSA. Panel (c) show adiagram illustrating TNF-α production in CD4+ T lymphocytes residingwithin the spleen of untreated mice (control) and of mice treated withTNBS or TNBS/PSA. Numbers within quadrants represent the percentage ofcells. Panel (d) a diagram illustrating analysis of the expression ofIL-12, IL-6, and IL-17 in spleen of untreated mice (control) and micetreated with TNBS or TNBS/PSA.

FIG. 17 shows inhibition of inflammation and death associated withsystemic septic shock following administration of ZPS according to someembodiments herein disclosed. Panel (a): shows a diagram illustratingTNF-a serum levels in mice 1 and 4 hours post-administration of 100 μgof LPS alone. Mice were either pre-treated with PBS or 50 ug of PSAthree times every other day before LPS administration. * indicatesstatistical significance as determined by a students t test. SD wasdetermined from the serum of individual mice. These data arerepresentative of three independent experiments. Panel (b): shows adiagram illustrating IL-6 serum levels in mice 1 and 4 hourspost-administration of 100 μg of LPS. Pre-treatment as in panel a *indicates statistical significance as determined by a students t test.SD was determined from the serum of individual mice. These data arerepresentative of three independent experiments. Panel (c): shows adiagram illustrating variation of the spleen weight in untreated mice(con) and in mice administered LPS within the intraperiotenal cavity(LPS) and pre-treated with PBS or PSA as in panel a . Each dotrepresents the weight of the spleen from an individual mouse. P valueswere determined by a students T test. Panel (d): shows a diagramillustrating the survival rate of animals undergoing septic shockinduced by high dose (500 μg) administration of LPS and pre-treated withPSA or PBS. N=12 mice in each group. Panel (e): shows a diagramillustrating the serum concentrations of TNF-a in micepost-administration of 500 μg of LPS alone or pre-treated with PSA orPBS. p values were determined by students T test. Each dot represents anindividual mouse. Panel (f) shows a diagram illustrating the serumconcentrations of IL-6 in mice post-administration of 500μg of LPS aloneand pre-treated with PSA or PBS. p values were determined by students Ttest. Each dot represents an individual mouse.

FIG. 18 shows inhibition of inflammation and death associated withsystemic septic shock following administration of ZPS according to someembodiments herein disclosed. Panel (a): shows a diagram illustratingTNF-a serum levels in mice pre-treated with PBS or PSA and administeredLPS. Serum was collected 1 and 4 hours post-administration of LPS inIL-10^(−/−) mice. * indicates statistical significance as determined bya students t test. SD was determined from the serum of individual mice.Panel (b): shows a diagram illustrating IL-6 serum level in micepre-treated with PSA or PBS. Serum was collected 1 and 4 hourspost-administration of LPS in IL-10^(−/−) mice. * indicates statisticalsignificance as determined by a students t test. SD was determined fromthe serum of individual mice Panel (c): shows a diagram illustratingpercent survival in mice post-administration of LPS alone or togetherwith PSA in IL-10^(−/−) mice. N=8 mice in each group.

FIG. 19 shows a diagram illustrating additional effects of ZPSadministration on inflamed tissues according to some embodiments hereindisclosed.

FIG. 20 shows a diagram illustrating percent survival in mice treatedwith PSA before and after colitis induction compared to a controlaccording to some embodiments herein described. In particular, 8 weekold Balb/c mice were orally gavaged with 50 μg of purified PSA threetimes every other day prior to TNBS induction and every other daythroughout the course of disease (triangle-PSA pre) or orally gavagedwith 50 μg of PSA 24 hours post-TNBS induction and every other daythroughout the course of disease (X). TNBS colitis was induced by rectaladministration of 100 ml of 1.25% TNBS in 50% ethanol. Control mice wererectally administered 50% ethanol as a vehicle control (diamonds).

FIG. 21 shows a diagram illustrating changes in weight of mice treatedwith PSA before and after colitis induction compared to a controlaccording to some embodiments herein described. Vehicle treated mice, noTNBS-diamond, PBS treated-with TNBS induction-squares, PSA treatmentprior to TNBS induction-triangles, PSA treatment after TNBSinduction-circles. Mice were weighed on the day of TNBS induction (day0) and every day thereafter at the same time of day. * indicates astatistical difference between groups.

FIG. 22 shows a diagram illustrating results of a histological analysisperformed in mice treated with PSA and/or TBS according to someembodiments herein described. In particular, the diagram of FIG. 22shows that the colitis score by a blinded pathologist in sections of thecolon of mice treated with TNBS only, or with PSA before or after TNBStreatment, as well as of control mice.

FIG. 23 shows a diagram illustrating results showing the percentage ofFoxp3 in a CD4+ CD25+ Treg subset in mice treated with PSA before andafter colitis induction compared to a control according to someembodiments herein described.

FIG. 24 shows diagrams illustrating results showing PSA ability toinduce functional Foxp3+ Tregs with an inducible phenotype according tosome embodiments herein described. Panel A shows results of experimentsin which Foxp3-GFP mice were orally gavaged with purified PSA, MLNsharvested and cells stained for CD4 and CD25. Each symbol represents the% of CD4+ Foxp3−GFP+ cells from a single mouse. Results arerepresentative of 3 independent trials with 4 mice per group. **p valueof <0.01. Panel B shows results of experiments in which CD4+CD25+ cellswere purified from the MLNs of mice treated with either PBS or PSA asindicated in A and incubated with CFSE-pulsed CD4+CD25− effector T cellsin an in vitro suppression assay. Numbers indicate the percentage ofcells undergoing at least one cellular division at 3 different ratios ofeffector T cells (Teff) and regulatory T cells (Treg). These data arerepresentative of 2 independent trials. Panel C shows results ofexperiments in which Foxp3-GFP mice were orally treated with purifiedPSA. MLNs were extracted and CD4+ Foxp3+ or the CD4+ Foxp3− T cells werepurified based on ±GFP expression (purity >99%). RNA was extracted andused for qRT-PCR. These data are representative of three independentexperiments. Light bars indicated cells derived from PBS treated miceand dark bars from PSA-treated mice. Panel D shows results ofexperiments in which TLR2−/− mice were orally treated with PSA. MLNswere extracted and analyzed for the percentage of CD4+ Foxp3+ cells.Each symbol in the bar graph represents the percentage of CD4+ Foxp3+from an individual mouse. NS, not significant. Results arerepresentative of 3 independent trials with at least 3 mice per group.Panel E shows results of experiments in which CD4+CD25hi+ and CD4+ CD25−T cell populations were FACS purified from MLNs of PSA-treated TLR2−/−mice. IL-10 levels were analyzed by qRT-PCR. Light and dark barsindicate IL-10 levels in PBS or PSA treated animals, respectively. Errorbars represent the SD from samples of the same experiment run intriplicate. Results are representative of 2 independent trials with 4mice per group.

FIG. 25 shows diagrams illustrating results showing PSA's ability toup-regulates the expression of genes for ICOS and Perforin according tosome embodiments herein described. Foxp3−GFP mice were orally treatedwith purified PSA every other day for 6 days. MLNs were extracted andCD4+Foxp3+ or the CD4+ Foxp3 T cells were purified by FACS based on ±GFPexpression (purity >99%). RNA was extracted and used for qRT-PCR. Thesedata are representative of three independent experiments. Light barsindicated cells derived from PBS treated mice and dark bars fromPSA-treated mice. Error bars represent SD from samples run in triplicatefrom a single experiment. These results represent three independenttrials.

FIG. 26 shows a diagram illustrating results showing IFN-γ levels in theMLNS in presence or absence of PSA according to some embodiments hereindescribed. Cells were taken from the MLN and stained with CD4, Foxp3 andIFN-γ. Plots are gated on CD4+ cells and numbers rounded to the nearesttenth. These are data are representative of three independent trials.

FIG. 27 shows a diagram illustrating results showing IFN-γ levels inspleen in presence or absence of PSA according to some embodimentsherein described. GF Rag−/− animals were colonized with B. fragilis orB. fragilisDPSA and CD4+Foxp331 T cell from Foxp3-GFP mice wereadoptively transferred. After 3 weeks, spleens were harvested and CD4+ Tcells stained for IL-10 and IFNγ after restimulation with PMA/Ionomycinin the presence of brefeldin A. Plots are gated on CD4+Foxp3− (GFP-)cells. Numbers are rounded to the nearest tenth.

FIG. 28 shows diagrams illustrating results showing PSA ability toexpand functional Foxp3+ Tregs during protection from experimentalcolitis according to some embodiments herein described. Panel A showsresults of experiments in which Balb/c mice were treated with PSA or PBSduring TNBS induced colitis and analyzed for the percentage ofCD25+Foxp3+ cells within the CD4+ population of the MLN. These data arerepresentative of 3 independent trials with 4 mice per group. Panel Bshows results of experiments in which mice were treated as in A, MLNcells were counted and absolute numbers of CD4+CD25+ Foxp3+ cellsdetermined (x10³). Numbers represent the average of 4 mice with errorbars indicting SD, and are representative of 3 independent trials. PanelC shows results of experiments in which RNA was extracted from the MLNsof mice treated with PSA and foxp3 transcript expression is shown,normalized to β-actin expression in the total lymph node. Numbersrepresent the average of 4 mice with error bars indicating SD, and arerepresentative of 3 independent trials. Panel D shows results ofexperiments in which CD4+CD25+ cells were purified from the MLNs ofcolitic PBS or PSA-treated mice and incubated with CFSE-pulsed CD4+CD25responder cells in an in vitro suppression assay. Numbers indicate thepercentage of cells undergoing at least one cellular division at 2different ratios of effector T cells (Teff) and regulatory T cells(Treg). These data are representative of 2 independent trials Panel Eshows results of experiments in which C57B1/6 WT or TLR2−/− animals weregavaged with purified PSA (or PBS) prior to TNBS administration. Colonswere fixed, sectioned and H&E stained. Representative histologicalsections are shown. Panel F shows results of experiments in whichColitis scores show that PSA protects WT but not TLR2−/− animals fromexperimental colitis. Each symbol represents a separate animal, and dataare from 2 independent trails. *p value of <0.05. NS, not significant.Panel G shows results of experiments in which RNA was extracted from theMLNs of indicated mice either treated with PBS or PSA, and theexpression levels of IL-10 and IL-17A were assayed by qRT-PCR. Relativeunits are represented as transcript levels relative to expression of ahousekeeping gene (L32). Results are representative of 3 independenttrials with 4 mice per group; error bars indicate SD. Panel H showsresults of experiments in which Percentages of CD4+CD25+ Foxp3+ T cellsin the MLNs of TLR2−/−mice treated with PBS or PSA during TNBS inducedcolitis. Plots are gated on CD4+ T cells. Results are representative of3 independent trials with 4 mice per group.

FIG. 29 shows a diagram illustrating results showing PSA's ability toexpand Tregs, but not B cells during experimental colitis according tosome embodiments herein described. The MLN of TNBS mice were analyzedfor the presence of B cells by FC staining for B220 and CD19. Theseresults are representative of three independent experiments.

FIG. 30 shows a diagram illustrating results showing PSA's ability toincrease the amount of Foxp3 protein during TNBS according to someembodiments herein described. Cells from the MLN were extracted fromindicated mice and stained with CD4 and Foxp3. Plots are gated on CD4+cells. The histogram indicates that PSA treated animals have a higherexpression of Foxp3 than cells from TNBS animals. These data arerepresentative of three independent experiments.

FIG. 31 shows diagrams illustrating results showing PSA's ability totreat animals with colitis according to some embodiments hereindescribed. Panel A shows results of experiments in which Balb/c micewere either pre-treated with PSA prior to administration of 1% TNBS(pre) or orally treated with PSA 24 hours after the administration ofTNBS (post). Mice were weighed daily for eight days. *p value of <0.05at the indicated time points. Panels B and C shows results ofexperiments in which Colons were extracted from groups of mice treatedas in A, fixed, sectioned and stained with H&E to determine diseaseseverity 5 days post-TNBS administration. Representative sections areshown in Panel B. Colitis scores are shown in Panel C. Data arerepresentative of three independent experiments, p values determined bya two-tailed Mann-Whitney U-test. **p value of <0.01. Panel D showsresults of experiments in which MLNs from indicated mice were extractedand cells stained with antibodies to detect for CD4, CD25 and Foxp3.Numbers indicate the percentage of CD25+ Foxp3+ cells within CD4+population of cells. Results are representative of 3 independent trialswith 4 mice per group; error bars indicate SD. Panel E shows results ofexperiments in which Balb/c mice were treated with PSA as indicated in Aand rectally administered 2% TNBS. Number of animals: 8 mice in thecontrol group, 7 in the pre-TNBS PSA group and 5 in the post-TNBS PSAgroups and 11 in the TNBS+PBS group. Data in E are the combination of 2independent experiments.

FIG. 32 shows diagrams illustrating results showing that PSA treatmentof animals after induction of TNBS colitis according to some embodimentsherein described up-regulates of IL-10 and Foxp3 expression . Balb/canimals were induced for TNBS colitis and subsequently given PBS 1 daypost TNBS induction (TNBS+PBS) or PSA 1 or 2 days post-TNBS induction(post-TNBS PSA 1 or 2). Five days post-TNBS treatment RNA was extractedfrom the colon and IL-10 and Foxp3 gene expression was assayed byqRT-PCR. Error bars represent the SD from samples run in triplicate fromone independent trial.

FIG. 33 shows a diagram illustrating results showing that PSA treatmentof colitic animals according to some embodiments herein describedresults in a decreased expression of inflammatory IL-17A. RNA wasextracted from the MLN of indicated animals and expression levels ofIL-17A were determined by qRT-PCR. Error bars indicate SD from fourindependent mice. *p value of <0.05. These data are representative ofthree independent trials.

FIG. 34 shows a diagram illustrating results showing that PSA'sadministration according to some embodiment herein described candecrease IL-6 in the serum. High doses of LPS (500 μg) were administeredi.p. to Balb/c mice. 10 or 30 minutes post LPS administration, PSA wasgiven retro-orbitally. 1 hour post-LPS, serum was collected and levelsof IL-6 were determined.

FIG. 35 shows a diagram illustrating results showing that PSA'sadministration according to some embodiment herein described candecrease TNF-α in the serum. High doses of LPS (500 μg) wereadministered i.p. to Balb/c mice. 10 or 30 minutes post LPSadministration, PSA was given retro-orbitally. 1 hour post-LPS, serumwas collected and levels of TNF-α were determined.

FIG. 36 shows a diagram illustrating results showing that PSA'sadministration according to some embodiment herein described canincrease survival of mice already suffering from endotoxic shock.

DETAILED DESCRIPTION

Methods and compositions are herein disclosed that allow balancing aT-helper cell profile in an individual, based on the use of PSA oranother zwitterionic polysaccharide.

The term “T-helper” as used herein with reference to cells indicates asub-group of lymphocytes (a type of white blood cell or leukocyte)including different cell types identifiable by a skilled person. Inparticular, T-helper cell according to the present disclosure includeeffector T_(h) cells (such as Th1, Th2 and Th17)-i.e. Th cells thatsecrete cytokines, proteins or peptides that stimulate or interact withother leukocytes, including T_(h) cells - and suppressor Th cells (suchas Treg) i.e. Th cells that suppress activation of the immune system andthereby maintain immune system homeostasis and tolerance toself-antigens. Mature T_(h) cells are believed to always express thesurface protein CD4. T cells expressing CD4 are also known as CD4⁺ Tcells. CD4⁺ T cells are generally treated as having a pre-defined roleas helper T cells within the immune system, although there are knownrare exceptions. For example, there are sub-groups of suppressor Tcells, natural killer T cells, and cytotoxic T cells that are known toexpress CD4 (although cytotoxic examples have been observed in extremelylow numbers in specific disease states, they are usually considerednon-existent).

The term “cell profile as used herein indicates a detectable set of dataportraying the characterizing features of a cell that distinguish thecharacterized cell from another. In particular, when referred to a Thelper cell, the wording “cell profile” indicates a detectable set ofdata related to a marker cytokine that is produced by the Th cell andcharacterizes the Th cell with respect to another. For example, markercytokine for Th1 cell is Interferon-g; marker cytokine for Th2 is IL-4,marker cytokine for Th7 is Il-17 and marker cytokine for Treg is IL-10.Accordingly, the wording “Th17 cell profile” as used herein indicatesthe detectable set of data, such as presence and amount, related toproduction of IL-17 in a certain organ or tissue of the individualwherein the presence and/or activity of Th1 cell is investigated.Similar definitions apply to the other Th cell types. On the other hand,when the wording “cell profile” is referred to a subset of Th cellincluding more then one Th cell type, the wording “T-helper cellprofile” indicates a detectable set of data related to each markercytokine that is produced by and characterizes each, of the T-helpercells of the subset.

The term “balance” as used herein with reference to a “Th cell profile”as used herein indicates the activity of bringing the cell profile to astatus associated with absence of an inflammatory response. Similarlythe term “balanced Th profile” indicates the Th cell profile statusassociated with absence of an inflammatory response and in particular tothe detectable set of data related to a marker cytokine that is producedby the T helper cell and characterizes the T helper cell with respect toanother in absence of an inflammatory response. When the term “T-helpercell” profile refers to a subset of Th cell including more then one Thcell type, the term “balanced Th profile” refers instead to the relativeratio between the detectable set of data related to each marker cytokinethat is produced by and characterizes each, of the T-helper cells. Forexample, a “balanced Th cell profile” referred to a Th cells subsetcomprising Th1, Th2 and Th17 indicates the relative ratio of datarelated to Interferon-gamma, IL-4 and IL17 associated with absence of aninflammatory response.

The term “zwitterionic polysaccharide” as used herein indicatessynthetic or natural polymers comprising one or more monosaccharidesjoined together by glicosidic bonds, and including at least onepositively charged moiety and at least one negatively charged moiety.Zwitterionic polysaccharides include but are not limited to polymers ofany length, from a mono- or di-saccharide polymer to polymers includinghundreds or thousands of monosaccharides. In some embodiments, azwitterionic polysaccharide can include repeating units wherein eachrepeating unit includes from two to ten monosaccharides, a positivelycharged moiety (e.g. an free positively charged amino moiety) and anegatively charged moiety (such as sulfonate, sulfate, phosphate andphosphonate). In some embodiment ZPs can have a molecular weightcomprised between 500 Da and 2,000,000 Da. In some embodiments, the ZPscan have a molecular weight comprised between 200 and 2500. ExemplaryZPS include but are not limited to PSA and PSB from BacteroidesFragilis, CP5/CD8 from Staphylococcus aureus, and Sp1/CP1 fromStreptococcus pneumonia. Zwitterionic polysaccharides can be isolatedfrom natural sources, and in particular from bacterial sources, e.g. bypurification. Zwitterionic polysaccharides can also be produced bychemical or biochemical methods, as well as by recombinant microorganismtechnologies all identifiable by a skilled person. Thus, those methodsand technologies will not be further described herein in detail.

The wording “polysaccharide A” as used herein indicates a moleculeproduced by the PSA locus of Bacteroides Fragilis and derivativesthereof which include but are not limited to polymers of the repeatingunit {→3)α-d-AATGalp(1→4)[^(β)-d-Galf(1→3)-]-d-GalpNAc(1→3)³-d-Galp(1→}, where AATGal isacetamido-amino-2,4,6-trideoxygalactose, and the galactopyranosylresidue is modified by a pyruvate substituent spanning O-4 and O-6 . Theterm “derivative” as used herein with reference to a firstpolysaccharide (e.g., PSA), indicates a second polysaccharide that isstructurally related to the first polysaccharide and is derivable fromthe first polysaccharide by a modification that introduces a featurethat is not present in the first polysaccharide while retainingfunctional properties of the first polysaccharide. Accordingly, aderivative polysaccharide of PSA, usually differs from the originalpolysaccharide by modification of the repeating units or of thesaccharidic component of one or more of the repeating units that mightor might not be associated with an additional function not present inthe original polysaccharide. A derivative polysaccharide of PSA retainshowever one or more functional activities that are herein described inconnection with PSA in association with the anti-inflammatory activityof PSA.

In some embodiments, the zwitterionic polysaccharide can be PSA and/orPSB. In some embodiments, the effective amount of ZP and in particularPSA and/or PSB is from about 1-100 micrograms to about 25 grams of bodyweight and the T-helper cell profile is balanced by balancing at leastone of Th1, Th2, Th17 and Treg, in particular at least one of Th1, Th 2and Treg and Th17. More particularly, in some embodiments, balance Thcell profile can be performed by balancing the Th17 cell profile.

In some embodiments, a ZP can be used to control cytokine productionassociated with inflammation in an individual. In particular, in someembodiments, ZPs can be administered to inhibit production ofpro-inflammatory cytokine molecules such as TNF-a, IL1 or IL-6, IL21,IL23 and IL17.

The term “control” as used herein indicates the activity of affectingand in particular inhibiting a biological reaction or process, whichinclude but are not limited to biological and in particular biochemicalevents occurring in a biological system, such as an organism (e.g.animal, plant, fungus, or micro-organism) or a portion thereof (e.g. acell, a tissue, an organ, an apparatus).

The terms “inhibiting” and “inhibit”, as used herein indicate theactivity of decreasing the biological reaction or process. Accordingly,a substance “inhibits” a certain biological reaction or process if it iscapable of decreasing that biological reaction or process by interferingwith said reaction or process. For example, a substance can inhibit acertain biological reaction or process by reducing or suppressing theactivity of another substance (e.g. an enzyme) associated to thebiological reaction or process, e.g. by binding, (in some casesspecifically), said other substance. Inhibition of the biologicalreaction or process can be detected by detection of an analyteassociated with the biological reaction or process. The term “detect” or“detection” as used herein indicates the determination of the existence,presence or fact of an analyte or related signal in a limited portion ofspace, including but not limited to a sample, a reaction mixture, amolecular complex and a substrate. A detection is “quantitative” when itrefers, relates to, or involves the measurement of quantity or amount ofthe analyte or related signal (also referred as quantitation), whichincludes but is not limited to any analysis designed to determine theamounts or proportions of the analyte or related signal. A detection is“qualitative” when it refers, relates to, or involves identification ofa quality or kind of the analyte or related signal in terms of relativeabundance to another analyte or related signal, which is not quantified.

The term “cytokine” as used herein indicates a category of signalingproteins and glycoproteins extensively used in cellular communicationthat are produced by a wide variety of hematopoietic andnon-hematopoietic cell types and can have autocrine, paracrine andendocrine effects, sometimes strongly dependent on the presence of otherchemicals. The cytokine family consists mainly of smaller, water-solubleproteins and glycoproteins with a mass between 8 and 30 kDa. Cytokinesare critical to the development and functioning of both the innate andadaptive immune response. They are often secreted by immune cells thathave encountered a pathogen, thereby activating and recruiting furtherimmune cells to increase the system's response to the pathogen.

Detection of inhibition of cytokine production can be performed bymethods known to a skilled person including but not limited to ELISA,Q-PCR and intracellular cytokine staining detected by FACs and any othermethods identifiable by a skilled person upon reading of the presentdisclosure.

In some embodiments, a ZP can be administered to inhibit production ofat least one of TNF-a, IL-6, IL-17, IL-21 and IL-23. In particular, insome of those embodiments ZP can be administered systemically and inparticular, orally, sub cutaneously, intra peritoneally, andintravenously. In some embodiments ZP can be administered in an amountbetween about 1 and about 100 micrograms/25 grams of body weight.

Methods and compositions are herein disclosed that allow control of aninflammation associated with an imbalanced Th cell profile and or toproduction of at least one of the pro-inflammatory cytokines IL-1, IL-6,TNF-a, IL-17, IL21, IL23, and TGF-β in an individual.

The term “inflammation” and “inflammatory response as used hereinindicate the complex biological response of vascular tissues of anindividual to harmful stimuli, such as pathogens, damaged cells, orirritants, and includes secretion of cytokines and more particularly ofpro-inflammatory cytokine, i.e. cytokines which are producedpredominantly by activated immune cells such as microglia and areinvolved in the amplification of inflammatory reactions. Exemplarypro-inflammatory cytokines include but are not limited to IL-1, IL-6,TNF-a, IL-17, IL21, IL23, and TGF-β. Exemplary inflammations includeacute inflammation and chronic inflammation. The wording “acuteinflammation” as used herein indicates a short-term processcharacterized by the classic signs of inflammation (swelling, redness,pain, heat, and loss of function) due to the infiltration of the tissuesby plasma and leukocytes. An acute inflammation typically occurs as longas the injurious stimulus is present and ceases once the stimulus hasbeen removed, broken down, or walled off by scarring (fibrosis). Thewording “chronic inflammation” as used herein indicates a conditioncharacterized by concurrent active inflammation, tissue destruction, andattempts at repair. Chronic inflammation is not characterized by theclassic signs of acute inflammation listed above. Instead, chronicallyinflamed tissue is characterized by the infiltration of mononuclearimmune cells (monocytes, macrophages, lymphocytes, and plasma cells),tissue destruction, and attempts at healing, which include angiogenesisand fibrosis. An inflammation can be controlled in the sense of thepresent disclosure by affecting and in particular inhibiting anyone ofthe events that form the complex biological response associated with aninflammation in an individual. In particular, in some embodiments, aninflammation can be controlled by affecting and in particular inhibitingcytokine production, and more particularly production ofpro-inflammatory cytokines, following administration of a zwitterionicpolysaccharide.

More particularly, in some embodiments, a ZP can be used to control aninflammation associated with IL-1, IL-6, TNF-a, IL-17, IL21, IL23,and/or TGF-β mediated inflammation in an individual. The wording“cytokine mediated inflammation” as used herein indicates aninflammation wherein the complex biological response to a harmfulstimulus is controlled by cytokine molecules, such as pro-inflammatorycytokine molecules (e.g. TNF-a, IL1 and/or IL-6) and anti-inflammatorycytokine molecules (e.g. IL-10). Exemplary cytokine mediatedinflammation include but are not limited to conditions mediated by IL-1,IL-6, TNF-α, IL-12p35, IL-17A, IL-21, IL-22, IFN-γ and/or IL-23p19.

In some embodiments, the cytokine is at least one of TNF-a, IL-17,IL-21, and IL-23 and the cytokine mediated inflammation is a IBD,asthma, type 1 diabetes, multiple sclerosis, obesity, type 2 diabetes,hay fever, food allergies, skin allergies, or rheumatoid arthritis.Reference is also made to Mazmanian et al 2008⁴³, in particular thefigures and related portion of the paper herein incorporated byreference in its entirety.

In some embodiments, the inflammation is a systemic inflammation.Systemic inflammations include but are not limited to an inflammatoryresponse in the circulatory system, an inflammatory response which isnot confined in a specific organ, and an inflammatory response thatextends to a plurality (up to all) tissues and organs in an individual.

In some embodiments, a ZP can be used to control an inflammationassociated with an imbalance of T-helper cell profile and in particularto a Th17 cell profile, including but not limited to rheumatoidarthritis, respiratory diseases, allograft rejection, systemic lupuserythematosis, tumorgenesis, multiple sclerosis, systemic sclerosis andchronic inflammatory bowel disease.

In some embodiments, PSA can be administered systemically to theindividual. The wording “systemic administration” as used hereinindicates a route of administration by which PSA is brought in contactwith the body of the individual, so that the desired effect is systemic(i.e. non limited to the specific tissue where the inflammation occurs).Systemic administration includes enteral and parenteral administration.Enteral administration is a systemic route of administration where thesubstance is given via the digestive tract, and includes but is notlimited to oral administration, administration by gastric feeding tube,administration by duodenal feeding tube, gastrostomy, enteral nutrition,and rectal administration. Parenteral administration is a systemic routeof administration where the substance is given by route other than thedigestive tract and includes but is not limited to intravenousadministration, intra-arterial administration, intramuscularadministration, subcutaneous administration, intradermal,administration, intraperitoneal administration, and intravesicalinfusion.

In some embodiments, administration is performed intravenously byintroducing a liquid formulation including a ZP in a vein of anindividual using intravenous access methods identifiable by a skilledperson, including access through the skin into a peripheral vein. Insome embodiments, administration of a ZP is performed intraperitoneally,by injecting a ZP in the peritoneum of an individual, and in particularof animals or humans. Intraperitoneal administration is generallypreferred when large amounts of blood replacement fluids are needed, orwhen low blood pressure or other problems prevent the use of a suitableblood vessel for intravenous injection. In some embodimentsadministration is performed intragastrically, including administrationthrough a feeding tube. In some embodiments, administration of a ZP isperformed intracranially. In some embodiments a ZP can be administeredtopically by applying the ZP usually included in an appropriateformulation directly where its action is desired. Topical administrationinclude but is not limited to epicutaneous administration, inhalationaladministration (e.g. in asthma medications), enema, eye drops (E.G. ontothe conjunctiva), ear drops, intranasal route (e.g. decongestant nasalsprays), and vaginal administration.

In some embodiments, the inflammation is an inflammation of in a tissueand in particular in pancreas, lungs, joints, skin, brains and centralnervous system, and eyes.

In some embodiments, PSA is used in a method of treating or preventing acondition associated with inflammation in an individual. The methodcomprises administering to the individual a therapeutically effectiveamount of the PSA. The term “individual” as used herein includes asingle biological organism wherein inflammation can occur including butnot limited to animals and in particular higher animals and inparticular vertebrates such as mammals and in particular human beings.

The term “condition” as used herein indicates a usually the physicalstatus of the body of an individual, as a whole or of one or more of itsparts, that does not conform to a physical status of the individual, asa whole or of one or more of its parts, that is associated with a stateof complete physical, mental and possibly social well-being. Conditionsherein described include but are not limited disorders and diseaseswherein the term “disorder” indicates a condition of the livingindividual that is associated to a functional abnormality of the body orof any of its parts, and the term “disease” indicates a condition of theliving individual that impairs normal functioning of the body or of anyof its parts and is typically manifested by distinguishing signs andsymptoms. Exemplary conditions include but are not limited to injuries,disabilities, disorders (including mental and physical disorders),syndromes, infections, deviant behaviors of the individual and atypicalvariations of structure and functions of the body of an individual orparts thereof.

The wording “associated to” as used herein with reference to two itemsindicates a relation between the two items such that the occurrence of afirst item is accompanied by the occurrence of the second item, whichincludes but is not limited to a cause-effect relation andsign/symptoms-disease relation.

Conditions associated with an inflammation include but are not limitedto inflammatory bowel disease, including but not limited to Chron'sdisease and ulcerative colitis, asthma, dermatitis, arthritis,myasthenia gravis, Grave's disease, sclerosis, psoriasis.

The term “treatment” as used herein indicates any activity that is partof a medical care for or deals with a condition medically or surgically.

The term “prevention” as used herein indicates any activity, whichreduces the burden of mortality or morbidity from a condition in anindividual. This takes place at primary, secondary and tertiaryprevention levels, wherein: a) primary prevention avoids the developmentof a disease; b) secondary prevention activities are aimed at earlydisease treatment, thereby increasing opportunities for interventions toprevent progression of the disease and emergence of symptoms; and c)tertiary prevention reduces the negative impact of an alreadyestablished disease by restoring function and reducing disease-relatedcomplications.

An effective amount and in particular a therapeutically effective amountof PSA is for example in the range of between about 1 μg to about 100 μgof PSA per 0.025 kilograms of body weight. In some embodiments, theeffective amount is in a range from about 001 to about 1,000 μg per 25grams of body weight.

In some embodiments, PSA is comprised in a composition together with asuitable vehicle. The term “vehicle” as used herein indicates any ofvarious media acting usually as solvents, carriers, binders or diluentsfor PSA comprised in the composition as an active ingredient.

In some embodiments, where the composition is to be administered to anindividual the composition can be a pharmaceutical anti-inflammatorycomposition, and comprises PSA and a pharmaceutically acceptablevehicle.

In some embodiments, PSA can be included in pharmaceutical compositionstogether with an excipient or diluent. In particular, in someembodiments, pharmaceutical compositions are disclosed which containPSA, in combination with one or more compatible and pharmaceuticallyacceptable vehicle, and in particular with pharmaceutically acceptablediluents or excipients.

The term “excipient” as used herein indicates an inactive substance usedas a carrier for the active ingredients of a medication. Suitableexcipients for the pharmaceutical compositions herein disclosed includeany substance that enhances the ability of the body of an individual toabsorb PSA. Suitable excipients also include any substance that can beused to bulk up formulations with PSA to allow for convenient andaccurate dosage. In addition to their use in the single-dosage quantity,excipients can be used in the manufacturing process to aid in thehandling of PSA. Depending on the route of administration, and form ofmedication, different excipients may be used. Exemplary excipientsinclude but are not limited to antiadherents, binders, coatingsdisintegrants, fillers, flavors (such as sweeteners) and colors,glidants, lubricants, preservatives, sorbents.

The term “diluent” as used herein indicates a diluting agent which isissued to dilute or carry an active ingredient of a composition.Suitable diluent include any substance that can decrease the viscosityof a medicinal preparation.

In certain embodiments, compositions and, in particular, pharmaceuticalcompositions can be formulated for systemic administration, whichincludes enteral and parenteral administration.

Exemplary compositions for parenteral administration include but are notlimited to sterile aqueous solutions, injectable solutions orsuspensions including PSA. In some embodiments, a composition forparenteral administration can be prepared at the time of use bydissolving a powdered composition, previously prepared in lyophilizedform, in a biologically compatible aqueous liquid (distilled water,physiological solution or other aqueous solution).

Exemplary compositions for enteral administration include but are notlimited to a tablet, a capsule, drops, and suppositories.

The Examples section of the present disclosure illustrates examples ofthe compositions and methods herein described as well as the studiescarried out by applicants in order to investigate the functional andphysical interactions of PSA.

Further advantages and characteristics of the present disclosure willbecome more apparent hereinafter from the following detailed disclosurein the Examples given by way or illustration only with reference to anexperimental section.

EXAMPLES

The methods and system herein disclosed are further illustrated in thefollowing examples, which are provided by way of illustration and arenot intended to be limiting.

In particular, in the following examples, the following materials andmethods were used.

Bacterial strains and animals. B. fragilis NCTC9343 and H. hepaticusATCC51149 were obtained from the American Type Culture Collection.Conventionally reared SPF mice of strains C57BL/6NTac, C57BL/6NTacIL-10^(−/−), and B6.129S6-Rag2^(iml/Fwa) N12 (Rag2^(−/−)) were purchasedfrom Taconic Farms (Germantown, N.Y.) and screened negative for B.fragilis and H. hepaticus . Swiss-Webster germ-free (SWGF) mice werepurchased from Taconic Farms. Upon delivery in sterile shippingcontainers, the mice were transferred to sterile isolators (ClassBiologically Clean, Madison, Wis.) in our animal facility. Animals werescreened weekly for bacterial, viral, and fungal contamination aspreviously described⁴⁰. All animals were cared for under establishedprotocols and the IACUC guidelines of Harvard Medical School and theCalifornia Institute of Technology.

Model of inflammation: Three models of intestinal inflammation wereused: 1) CD4⁺CD45Rb^(high) T cells were purified from the spleens ofwild-type or IL-10^(−/−) donor mice by flow cytometry and transferredinto Rag^(−/−)(C57B^(1/6)) recipients as described. 2) TNBS colitis wasinduced by pre-sensitization of wild-type (C57B1/6) mice on the skinwith a TNBS/acetone mix. Seven days after sensitization, 2.5% TNBS inethanol was administered rectally; mice were sacrificed 3-6 days later.3) IL10^(−/−) mice were colonized (by oral gavage) with H. hepaticusalone or in combination with wild-type B. fragilis or B. fragilis ΔPSA.

Assays and scoring systems: Cytokines from the spleen, colons, or MLNswere assayed by ELISA, Q-PCR, or flow cytometry. Colitis was assessedwith tissue sections (fixed, paraffin embedded, sectioned onto a slide,and stained with hematoxylin and eosin) and was scored by a blindedpathologist (Dr. R.T. Bronson, Harvard Medical School) according to astandard scoring system: 0, no thickening of colonic tissues and noinflammation (infiltration of lymphocytes); 1, mild thickening oftissues but no inflammation; 2, mild thickening of tissues and mildinflammation; 3, severe thickening and severe inflammation. BMDCs werepurified from femurs of mice after extraction and washing in PBS. Cellswere cultured for 8 days in C-RPMI-10 in the presence of GM-CSF (20ng/mL; Biosource, Camarillo, CA). CD4⁺ T cells were purified by negativeselection over a magnetic column (Miltenyi or R& D Systems).

Flow cytometry, fluorescence-activated cell sorting (FACS), andstaining. Lymphocytes were isolated from mouse spleens that weremechanically disrupted into single-cell preparations. Red blood cellswere lysed, and splenocytes (1×10⁶) were incubated with variouscombinations of antibodies (BD Pharmingen, San Diego, Calif.) at 2 mg/mLfor 30 min at 4° C. Cells were then washed and either fixed or useddirectly. For intracellular cytokine flow cytometry, samples wereanalyzed on a model FC500 cytometer (Beckman Coulter, Fullerton, Calif.)or a FacsCalibur (Becton Dickson), and data were analyzed with RXPAnalysis Software (Beckman Coulter) or FlowJO. FACS was performed on aBD FACSAria, and cell purity was always >99%.

In vitro cytokine assays. For colon organ cultures, procedures werefollowed as previously reported⁴¹. For co-culture, CD4⁺ T cells werepurified from splenic lymphocytes (prepared as described above) with aCD4⁺ T Cell Subset Kit (R&D Systems, Minneapolis, Minn.) used asinstructed by the manufacturer. Cell purity was always >95%. BMDCs werepurified from femurs of mice after extraction and washing in PBS. Cellswere cultured for 8 days in C-RPMI-10 in the presence of GM-CSF (20ng/mL; Biosource, Camarillo, Calif.). Medium was replaced after 4 days,and adherent cells were cultured for an additional 4 days, at whichpoint nonadherent cells were recovered, washed, and used directly. Cellswere >95% CD11c⁺ at the time of use. Purified CD4⁺ T cells (1×10⁶) weremixed with purified CD11c⁺ BMDCs (1×10⁶) in a 48-well plate and wereincubated at 37° C. in an atmosphere containing 5% CO₂. Various stimuliwere used, as described in Results. ELISA was performed with pre-coatedplate kits (BD Pharmingen) according to the manufacturer's guidelines.In some assays, H. hepaticus, with or without wild-type B. fragilis orB. fragilis ΔPSA, was added at various concentrations.

Induction of experimental colitis. As assessed by PCR, Rag2^(−/−) andcontrol C57B1/6 mice were negative for H. hepaticus colonization at thetime of delivery. Splenic lymphocytes were harvested from wild-typedonor mice, and CD4⁺CD45Rb^(high) cells were purified from lymphocytepopulations by FACS as described above. Cells were washed with PBS, and3×10⁵ cells were injected intraperitoneally in a volume of 0.2 mL intorecipient H. hepaticus-colonized Rag2^(−/−) animals. For colonizationexperiments, both H. hepaticus (1×10⁸ organisms) and B. fragilis (1×10⁸organisms) were introduced at the time of cell transfer. Throughout PSAtreatment studies, animals received 50 μg of PSA by gavage 3 times perweek. Animals were weighed throughout the experiment until sacrifice at8 weeks.

Induction of intestinal inflammation-TNBS colitis. The backs ofwild-type (C57BL/6) male mice were shaved, and pre-sensitizationsolution (150 μL; acetone with olive oil in a 4:1 ratio mixed with 5%TNBS in a 4:1 ratio) was slowly applied. Seven days after sensitization,mice were anesthetized with isofluorene and TNBS solution (100 μL; 1:15% TNBS with absolute ethanol) administered rectally through a 3.5Fcatheter (Instech Solomon; SIL-C35). Mice were analyzed 4-6 days afterTNBS administration.

Histologic tissue analysis. Mouse tissues in Bouin's fixative (VWR, WestChester, Pa.) were embedded in paraffin, sectioned (6-μm slices),mounted onto slides, and stained with hematoxylin and eosin. Sectionswere evaluated in blinded fashion by a single pathologist (Dr. R. T.Bronson, Harvard Medical School).

Quantitative real-time PCR. RNA was extracted with Trizol per themanufacturer's instructions (Invitrogen). RNA (1 μg) was reversetranscribed into cDNA with an iScript cDNA synthesis kit (Bio-Rad). cDNAwas diluted by addition of 60 μL of water, and a 2-μL volume of thissolution was used for Q-PCR. Q-PCR was performed using IQ SYBR Greensupermix (Bio-Rad) and primers were used at 0.2 μm. Q-PCR was performedon a Bio-Rad iCycler IQ5. Sequences of Q-PCR primers were as follows5′-3′: IL-23 (p19) F: AGC TAT GAA TCT ACT AAG AGA GGG ACA (SEQ ID NO: 5)R: GTC CTA GTA GGG AGG TGT GAA GTT G (SEQ ID NO: 6). IL-17A F: TTA AGGTTC TCT CCT CTG AA(SEQ ID NO: 7) R: TAG GGA GCT AAA TTA TCC AA. (SEQ IDNO: 8) TNFαF: ACG GCA TGG ATC TCA AAG AC (SEQ ID NO: 9) R: GTG GGT GAGGAG CAC GTA GT (SEQ ID NO: 10). IL-10 F: CTG GAC AAC ATA CTG CTA ACC G(SEQ ID NO: 11) R: GGG CAT CAC TTC TAC CAG GTA A(SEQ ID NO: 12) RORγT F:CCG CTG AGA GGG CTT CAC (SEQ ID NO: 13) R: TGC AGG AGT AGG CCA CAT TAC A(SEQ ID NO: 14) IL-21 F: ATC CTG AAC TTC TAT CAG CTC CAC (SEQ ID NO: 15)R: GCA TTT AGC TAT GTG CTT CTG TTT C (SEQ ID NO: 16) IL-27 F: CTG TTGCTG CTA CCC TTG CTT (SEQ ID NO: 17) R: CAC TCC TGG CAA TCG AGA TTC (SEQID NO: 18).

Example 1 PSA Balances the Th1/Th2 Profile of the Mammalian ImmuneSystem

The two subtypes of effector CD4⁺ T cells, T_(H)1 and T_(H)2, aredefined by expression of the cytokines interferon g (IFNg) andinterleukin 4 (IL-4), respectively (Janeway et al., 2001). As shownabove, PSA induces CD4⁺ T cell expansion in B. fragilis-colonized miceand in vitro. To further characterize the effects of PSA-mediated T cellactivation, we assessed cytokine profiles using purified cellularcomponents. Co-culture of DCs and CD4⁺ T cells in the presence of PSAyields dose-dependent up-expression of the T_(H)1 cytokine IFNg. Thelevel of IFNg production associated with PSA is comparable to thatassociated with several known potent IFNg inducers (a-CD3, LPS, andstaphylococcal enterotoxin A [SEA]) and requires both DCs and T cells.Specificity is evidenced by the lack of T_(H)1 cytokine production afterNAc-PSA treatment.

T_(H)1 cytokine production suppresses T_(H)2 responses; conversely,T_(H)2 cytokine expression inhibits T_(H)1 responses. Normal immuneresponses require a controlled balance of these opposing signals.Examination of IL-4 expression in response to PSA treatment reveals nocytokine production by purified CD4⁺ T cells. a-CD3 and the superantigenSEA are potent stimulators of both classes of cytokine. As T_(H)2cytokine production is a “default pathway” in many systems (Kidd, 2003;Amsen et al. 2004)) and T_(H)1 cytokine production is antagonistic toT_(H)2 expression, the specific stimulation of IFNg by PSA in vitro mayprovide a mechanism for establishing commensal-mediated homeostasis ofthe host immune system by balancing T_(H)1/T_(H)2 responses.

Example 2 PSA Is Required for Appropriate CD4⁺ T-Helper CytokineProduction During Colonization

A proper T_(H)1/T_(H)2 balance is critical for human and animal health;over- or underproduction of either response is associated withimmunologic disorders. We investigated the effects of PSA onT_(H)1/T_(H)2 cytokine responses in colonized animals, again usinggerm-free mice. CD4⁺ T cells from mouse spleens were purified and testedby ELISA for cytokine production. Overproduction of the T_(H)2 cytokineIL-4 in spleens of germ-free mice compared with levels in conventionalmice. This result is consistent with previous reports of the appreciablyT_(H)2-skewed profile of mice devoid of bacterial contamination andreflects the human neonatal (precolonization) cytokine profile(Kirjavainen and Gibson, 1999; Prescott et al., 1998; Adkins, 2000;Kidd, 2003). This “default” T_(H)2-bias in the absence of bacterialcolonization again highlights the profound contributions of themicroflora to immune development and provides a model to test theeffects of symbiotic bacteria on the establishment of appropriate hostcytokine production.

Mice colonized with wild-type B. fragilis alone display a level of IL-4production similar to that in conventional mice with a complexmicroflora; this similarity shows the organism's sufficiency to correctsystemic immune defects. Moreover, mice colonized with B. fragilis DPSAproduce T_(H)2 cytokines at elevated levels similar to those ingerm-free mice. Thus the expression of a single bacterial antigen allowsB. fragilis to correct the IL-4 cytokine imbalance found in uncolonizedanimals.

Examination of IFNg production by purified splenic CD4⁺ T cells revealsthat germ-free mice, which are T_(H)2-skewed, are deficient inproduction of this prototypical T_(H)1 marker when compared toconventional mice. Colonization with wild-type B. fragilis alone issufficient to correct the defect in IFNg expression in germ-free mice,with levels nearly as high as those in conventional mice. Lack of PSAproduction by the B. fragilis mutant during colonization of germ-freemice results in low-level production of T_(H)1 cytokines. These resultswere corroborated by intracellular cytokine staining of spleniclymphocytes from each group, which confirms that IFNg production isattributable to CD4⁺ T cells. The production of IL-2, another T_(H)1cytokine, by CD4⁺ T cells in gnotobiotic mice also requires PSAproduction data not shown) Together, these results demonstrate thatintestinal colonization of germ-free mice by B. fragilis alone issufficient to establish a proper systemic T_(H)1/T_(H)2 balance withinthe host—a fundamental aspect of the mammalian immune response requiredfor health.

Example 3 PSA Suppresses Th-17 Induced Inflammation

Experimental colitis and human IBD result from an initial inflammatoryresponse that—lacking repression—advances in an uncontrolled fashion andultimately leads to intestinal pathology and disease. To elucidate howPSA affects these primary inflammatory responses, Applicants employed ananimal model of chemically induced colonic inflammation. Rectaladministration of trinitrobenzene sulphonic acid (TNBS) to wild-typemice mimics the initiation of colitis by eliciting inflammatory T cellresponses. Disease was induced by administration of TNBS (or vehicle, asa negative control), and oral treatment of PSA was evaluated.

The results illustrated in FIG. 7 show that the intestinal immuneresponse are beneficially modulated by PSA. In particular, the resultsillustrated in FIG. 7a show that TNBS-treated animals display weightloss that is statistically significant relative to figures forvehicle-treated and PSA-treated animals, although partial weight loss isobserved in the PSA group (FIG. 7a ). Histological analysis confirmedPSA protection of colonic tissues against the massive epithelialhyperplasia and loss of colonocyte organization seen after TNBStreatment (FIG. 7b ). Studies have shown that pathogenic T_(H)17 cells,which produce IL-17, mediate the induction of experimental colitis³⁰.Indeed, IL-17 levels are increased among purified CD4⁺ T cells frommesenteric lymph nodes (MLNs; FIG. 7c ) of diseased animals but not fromthose of PSA-treated animals. The increased level of TNFa among CD4⁺ Tcells from MLNs of TNBS-treated animals is also reduced in PSA-treatedgroups (FIG. 7d ). Transcriptional analysis of TNBS-treated colonsrevealed that expression of both IL-17 and TNFa is highly elevated indiseased but not in PSA-protected animals (FIGS. 7e and 7f ).

Therefore, the above results show that PSA inhibits intestinal pathologyand inflammation in a chemically induced model of experimental colitis.

Example 4 PSA Induces the Differentiation of IL-10 Producing Treg toSuppress Inflammation

Protection from experimental colitis is engendered throughanti-inflammatory processes that prevent undesirable reactions againstthe intestinal microbiota²³. Interleukin-10-deficient (IL-10^(−/−))animals develop colitis³¹. IL-10, one of the most potentanti-inflammatory cytokines, is required for protection in many animalmodels of inflammation^(21, 27,32).

The results of a series of experiments directed to test the effect ofPSA on IL-10 production are illustrated in FIG. 8, and show that PSAinduces IL-10 expression in TNBS-treated animals and inhibitspro-inflammatory cytokine production in primary cultured cells throughIL-10 production. In particular, as assayed by real-time PCR,transcriptional levels of IL-10 within colons of PSA-treated mice aresignificantly higher than those in control and TNBS-treated mice (FIG.8a ). IL-10 is produced by many cell types. However, since CD4⁺ T cellsthat express IL-10 display immunosuppressive activities that inhibitinflammation during experimental colitis³³, Applicants tested the IL-10production in CD4⁺ T. When fresh CD4⁺ T cells were purified from MLNs ofPSA-treated mice (in which inflammation is reduced), highly elevatedlevels of the IL-10 transcript were observed (FIG. 8b ). Applicants thenassessed whether PSA is sufficient to induce IL-10 in vitro; when bonemarrow—derived dendritic cells (BMDCs) and naïve CD4⁺ T cells weretreated with purified PSA, a specific increase in IL-10 production wasobserved (FIG. 8c ).

A further series of experiments illustrated in FIG. 9, shows that PSAfrom B. fragilis induces expression of IL-10 in vitro. In particular,BMDCs and naïve CD4⁺ T cells were infected with H. hepaticus co-culturedwith B. fragilis, and a specific expression of IL-10 from culturesupernatants was observed; co-culture with B. fragilis DPSA inducessignificantly lower levels of IL-10 (FIG. 9). Since PSA inducesexpression of IL-10 in vitro, to test whether this molecule is requiredfor inhibition of inflammatory responses to H. hepaticus , BMDC-T cellco-cultures were infected with live H. hepaticus and measured expressionof the critical pro-inflammatory cytokine TNFa. Addition of increasingconcentrations of the pathogenic commensal causes a dose-dependentincrease in TNFa production, as measured by ELISA of culturesupernatants (FIG. 8d ; left three bars). Treatment of cells withpurified PSA markedly decreases TNFa production in response to H.hepaticus (FIG. 8d ; middle three bars). Most importantly, co-incubationof cell cultures with H. hepaticus and PSA in the presence of aneutralizing IL-10 receptor antibody (aIL-10R) completely reverses thisphenotypic effect and increases expression of TNFa (FIG. 8d ; rightthree bars).

The results are similar for the related pro-inflammatory cytokine IL-1b,as shown by the results of experiments illustrated in FIG. 10. Inparticular, infection of BMDC-T cell co-cultures with increasingconcentrations of live H. hepaticus (see FIG. 10 multiplicity ofinfection: 0.1, 1.0, and 10, as depicted by triangles) results inrelease of the cytokine IL-1b Treatment of infected cells with PSAreduces IL-1b levels, as shown in the middle three bars. Neutralizationof IL-10 signaling by addition of an IL-10 receptor antibody (aIL-10R)alleviates suppression of in vitro inflammatory responses, resulting inincreased levels of IL-1b FIG. 10 left three bars.

Thus, the results illustrated in the present example support theconclusion that IL-10 produced in response to PSA is required forinhibition of inflammatory reactions in cell cultures.

Example 5 PSA Administration Results in Differentiation of Treg,Inhibition of TNF-a and IL-17 Cytokine Production and in ColitisSuppression

Applicants investigated the requirement for IL-10 in suppression ofintestinal inflammation. Initially, IL-10^(−/−) animals were colonizedwith H. hepaticus alone or in combination with B. fragilis (wild-type orDPSA). Applicants subsequently harvested MLNs and re-stimulated cells inculture with soluble Helicobacter antigens in an assay previouslydeveloped to measure antigen-specific responses to H. hepaticus ²⁷. Inparticular, IL-10^(−/−) mice were left uncolonized (control) or werecolonized with H. hepaticus (to induce inflammation) either alone or incombination with B. fragilis (wild-type or ΔPSA). MLNs from experimentalgroups were pooled and re-stimulated with soluble Helicobacter antigen(5 μg/ml) for 48 hours. Secretion of pro-inflammatory cytokines TNFa (a)and IL-17A (b) was analyzed by ELISA.

The results of these experiments, illustrated in FIGS. 11a-11c , showthat Helicobacter-colonized animals display increased production of TNFaand IL-17; however, in the absence of IL-10 production in colonizedanimals, B. fragilis co-colonization dos not reduce levels of thesepro-inflammatory molecules (FIGS. 11a and b, respectively). As expected,the absence of PSA has no effect. Using the cell transfer model ofcolitis (see Examples 6 to 8 below, Applicants transferredCD4⁺CD45Rb^(high) T cells to Helicobacter-colonized Rag^(−/−) animals.Administration of aIL-10R to mice (to block IL-10 signaling) during oraltreatment with PSA abrogates protection from colitis (FIG. 11c ). Inparticular, colitis scores show that PSA protection requires aIL-10signaling, as neutralizing antibodies to IL-10 block PSA's suppressiveactivity. Treatment with IL-10R abrogates PSA-mediated protection. (FIG.11c ).

Additionally, when IL-10^(−/−) animals were treated with TNBS in thepresence or absence of PSA, weight and histology data illustrated inFIGS. 12 and 13, indicated that IL-10 production is required forPSA-elicited reduction of intestinal immune responses. In particular, ina first series of experiments, groups of 4 C57BL/6 mice were treatedwith PSA (or PBS) and then subjected to rectal administration of TNBS orvehicle (control). SD values illustrated in FIG. 12, indicate that, inthe absence of IL-10, PSA cannot restore TNBS-induced weight loss. ANOVAdemonstrates that weight loss in both TNBS-treated groups isstatistically different from that in control animals and that PSA doesnot prevent weight loss in TNBS-treated IL-10^(−/−) animals (FIG. 12).

In a second series of experiments, groups of 4 C57BL/6 mice were treatedwith PSA (or PBS) and then subjected to rectal administration of TNBS orvehicle (control). Histologic analysis of H&E-stained sections from arepresentative animal from each group is shown in FIG. 13. Thickening ofthe colon and epithelial hyperplasia are noted in both TNBS-treatedgroups of IL-10^(−/−) animals, regardless of PSA treatment. Thus, theresults illustrated in FIG. 13 show that in the absence of IL-10, PSAdoes not reduce intestinal injury in TNBS-treated IL-10^(−/−) mice.

The above data suggest that PSA-mediated protection entails thegeneration and/or expansion of IL-10-producing CD4⁺ T cells. Todetermine whether IL-10 production by CD4⁺ T cells is required forprotection, Applicants transferred CD4⁺CD45Rb^(high) T cells fromIL-10^(−/−) donor mice into Rag^(−/−) recipients and then colonized therecipients with H. hepaticus.

The results illustrated in FIGS. 11d-11f show that, as expected, groupsof mice receiving IL-10^(−/−) T cells along with H. hepaticus developsevere colitis (FIG. 11d left bar) and are not protected by PSA (FIG.11d ; middle bar). This result, supported by histological findings incolons, indicates that PSA induces protection from “previouslypathogenic” CD4⁺CD45Rb^(high) T cells in an IL-10-dependent manner (FIG.11e ). Weight analysis at sacrifice shows that colitic PBS- andPSA-treated animals receiving IL-10^(−/−) CD4⁺CD45Rb^(high) T cells(unlike control animals receiving no transferred cells) develop wastingdisease (FIG. 11f ). Thus, IL-10 production by CD4⁺ T cells is requiredfor PSA-mediated protection from experimental colitis. These resultsconstitute the first reported evidence of a symbiotic bacterial moleculethat networks with the immune system to coordinate anti-inflammatoryresponses required for mammalian health.

Example 6 PSA Balances the CD4⁺CD45Rb^(high)/CD4⁺CD45Rb^(low) T CellsRatio

CD4⁺ T cells of the mammalian immune system can be generally dividedinto a naïve (‘uneducated’) CD4⁺CD45Rb^(high) population and anantigen-experienced (‘educated’) CD4⁺CD45Rb^(low) population¹⁶.

In a first series of experiments, mono-association of germ-free micewith wild-type B. fragilis was performed to analyze the effect on theCD4⁻CD45Rb^(low) T cells v. CD4⁺CD45Rb^(high) proportion. In particular,the ability of B. fragilis to correct deficiencies in theCD4⁻CD45Rb^(low) T cell population in spleen.

The results illustrated in FIG. 1a show that association of B. fragilisexpands the proportions of CD4⁺CD45Rb^(low) T cells in a PSA-dependentmanner Remarkably, Applicants found that splenic cells from germ-freeanimals include a smaller proportion of CD4⁺CD45Rb^(low) T cells than dothose from age-matched conventional mice with a complete bacterialmicrobiota (FIG. 1a ). Additionally, it appears that mono-colonizationof germ-free mice with wild-type B. fragilis alone restores theCD4⁺CD45Rb profile in animals with a complete bacterial microbiota (FIG.1a ; left panels). Most notably, colonization with a mutant straindefective in the ability to produce PSA (B. fragilis DPSA) does notgenerate an expansion of the CD4⁺CD45Rb^(low) T cell population (FIG. 1a; lower right). It is well established that the latter populationpossesses potent anti-inflammatory properties and confers protection inanimal models of inflammation¹⁷. These results suggested that PSAmediate protection from inflammation.

Example 7 PSA Controls IL23, IL1b and TNF-a Production in InflamedTissues, thus Controlling Th17 and Th1-Mediated Cytokine Production

The well-established CD4⁻CD45Rb transfer model of experimental colitis¹⁸was employed to investigate whether B. fragilis colonization protectsanimals from inflammatory disease. In this model, pathogenicCD4⁺CD45Rb^(high) T cells are separated from protective CD4⁺CD45Rb^(low)cells and transferred into specific pathogen-free (SPF) Rag^(−/−) mice.Upon cell transfer, mice are colonized with i Helicobacterhepaticus^(8,19), a pathobiont that is a benign commensal in wild-typeanimals but an opportunistic pathogen causing colitis inimmuncompromised mice. After 8 weeks, animals are sacrificed and colitisis assessed with a standard scoring system²⁰.

The pathology scores illustrated in FIG. 1b , show that H. hepaticuscolonization and CD4⁺CD45Rb^(high) T cell transfer are sufficient toinduce severe colitis in Rag^(−/−) mice (FIG. 1b ; first column), aspreviously reported^(19,21). Co-colonization with wild-type B. fragilisresults in significant protection from disease (FIG. 1b ; secondcolumn), whereas co-colonization with B. fragilis DPSA does not (FIG. 1b; third column).

Tissue damage in colitis is widely believed to result from production ofinflammatory cytokines in response to commensal bacteria²². Thepro-inflammatory cytokines tumor necrosis factor a (TNFa, interleukin-lb(IL-lb and IL-23 are central to disease initiation and progression inthis experimental model of colitis²³. Furthermore, levels of thesecytokines are elevated in patients with IBD²⁴, and therapiesneutralizing TNFa have yielded promising results in clinical trials inpatients with Crohn's disease²⁵. Accordingly, Applicants decided to testthe inflammatory cytokine levels during disease by directly culturingintestinal tissues of T cell recipient colonized animals²⁶. The resultsillustrated in FIGS. 1c, 1d , 2 and 3 show that PSA alters cytokinelevels in affected tissue.

In particular, the results of ELISA experiments of colon organ culturesillustrated in FIG. 1c show an increased expression of pro-inflammatorycytokine TNFa in diseased colons, with significant reductions in animalsco-colonized with wild-type B. fragilis but not with B. fragilis DPSA.

The results of Q-PCR for IL-23p19 performed on splenocytes, normalizedto L32 expression illustrated in FIG. 1d show that increases in IL-23production by splenocytes following disease induction are completelysuppressed by intestinal colonization with PSA-producing B. fragilis.

ELISA results for the pro-inflammatory cytokines IL-12p40 and IL-1 b incolon and small intestines shown in FIG. 2 show a specific increase inpro-inflammatory cytokines in diseased colons but not in smallintestines. This increase is significantly reduced in animalsco-colonized with PSA-producing B. fragilis. Conversely, animalscolonized with B. fragilis DPSA express greatly increasedpro-inflammatory cytokine levels over those in control animals (C57BL/6)(FIG. 2).

The results of experiments illustrated in FIG. 3 show that theexpression of the TNFa by CD4⁺ T cells is reduced by wild-type B.fragilis colonization during experimental colitis. CD4⁺ cells werepurified from pooled splenocytes from each group (4 mice per group) andrestimulated in vitro with PMA and ionomycin in the presence ofbrefeldin A for 4 hours. Cells were stained for intracellular TNFα.Cells within the lymphocyte gate were included in the analysis, andnumbers indicate the percentage of cells producing TNFα. Purified cellswere >90% CD4⁺. Animals colonized with PSA-producing B. fragilis duringprotection displayed lower TNFa levels than diseased animals.

Overall these above results show that PSA performs its effect byaltering cytokine levels in affected tissues. In particular, levels ofthe pro-inflammatory cytokines TNFa (FIG. 1c ), IL-12p40, and IL-1b(FIG. 2) are elevated in the colons of Rag^(−/−) recipient micecolonized with H. hepaticus but not in sections of small intestine (asite not affected in this model). Consistent with the protectionobserved by pathophysiologic analysis of experimental colitis, TNFalevels are not elevated when these animals are co-colonized withwild-type B. fragilis. T cell transfer plus co-colonization with H.hepaticus and B. fragilis DPSA results in increased colonic cytokineproduction similar to that seen in Rag^(−/−) animals colonized with H.hepaticus alone. Moreover, purified splenic CD4⁺ T cells from H.hepaticus-colonized animals, display increased TNFa production; thiscondition is corrected by colonization with wild-type B. fragilis butnot with the PSA deletion strain (FIG. 3). Expression of IL-23 iscritical in the cascade of events leading to experimentalcolitis^(27, 28). Applicants found that increases in IL-23 production bysplenocytes following disease induction are completely suppressed byintestinal colonization with PSA-producing B. fragilis (FIG. 1d ).

Experiments directed to rule out bacterial clearance were performed toshow whether, over the course of the experiments, levels of H. hepaticusand B. fragilis colonization did differ between groups. The resultsillustrated in FIGS. 4 and 5 show that protection is not the result ofbacterial clearance.

In particular, the results shown in FIG. 4 show that experimentalanimals remain colonized with H. hepaticus and B. fragilis throughoutthe course of disease. More particularly, the ethidium bromide-stainedgel electrophoresis of H. hepaticus-specific Q-PCR of FIG. 4a shows thatco-colonization with B. fragilis does not induce clearance of bacteriaafter 8 weeks. The primers used for H. hepaticus 16S rDNA were: (HB-15)5′-GAAACTGTTACTCTG-3′ (SEQ ID NO: 1) and (HB-17)5′-TCAAGCTCCCCGAAGGG-3′(SEQ ID NO: 2). Ethidium bromide-stained gelelectrophoresis of B. fragilis-specific Q-PCR of FIG. 4b show stablebacterial colonization after 8 weeks; the primers used for B. fragilisssr3 (finB) gene were: (ssr3-F) 5′-TATTTGCGAGAAGGTGAT-3′ (SEQ ID NO: 3)and (ssr3-r) 5′-TAAACGCTTTGCTGCTAT-3′ (SEQ ID NO: 4).

In an additional series of experiments, quantitation of H. hepaticus wasperformed to verify whether PSA administration affected the presence ofthe organism. The results of quantitation of H. hepaticus colonizationexperiments of FIG. 5 demonstrate that the organism is present in equalnumbers regardless of PSA-mediated protection. In particular, in theexperiments of FIG. 5 fecal samples were collected from eachexperimental group, and total DNA was extracted (Qiagen DNAeasy tissuekit). Equal amounts of DNA (50 ng) were used in Q-PCR (Bio-rad) with H.hepaticus-specific primers. Q-PCR for H. hepaticus colonization wasassessed according to Young et al., 2004¹ as log¹⁰ number of copies of aknown gene (cytolethal distending toxin). Animals contained equivalentlevels of H. hepaticus at the end of the experiment.

The results illustrated in this example support the conclusion that PSAis a specific immunomodulatory molecule that orchestrates beneficialimmune responses to prevent B. Fragilis host from developingexperimental colitis.

Example 8 PSA Suppresses Inflammation Associated with CD4⁺CD45Rb^(high)T Cells

To determine whether PSA is sufficient for protection in the absence ofthe intact B. fragilis organism, Applicants purified PSA tohomogeneity²⁹ and administered it by gavage (orally) to Rag^(−/−)mice.Disease progression was then measured by various pathologic andhistologic criteria.

The results of related experiments illustrated in FIG. 6, show thatpurified PSA orally administered protects against experimental colitis.

In particular, in a first series of experiments illustrated in FIG. 6a ,colitis scores after CD4⁺CD45Rb^(high) T cell transfer in the absence ofH. hepaticus-colonization indicated the development of very mild colitisdue to inflammation elicited by the animals' SPF microbiota (FIG. 6a ;first column). However, Helicobacter-colonized Rag^(−/−)animals thatreceive CD4⁺CD45Rb^(high) T cell transfers develop severe colitis (FIG.6a ; second column). Oral PSA administration almost completely protectsanimals against H. hepaticus-induced colitis (FIG. 6a ; third column),reducing disease to levels of control animals without T cell transfer,that known not to develop colitis (FIG. 6a ; fourth column).

A second set of experiments was then performed to test the inability togain weight, a hallmark of colitis in this experimental setting⁴. Inparticular, transfer of CD4⁺CD45Rb^(high) T cells and colonization withH. hepaticus (PBS+Hh) in Rag2^(−/−) animals was performed and theanimals were subsequently tested for wasting disease. The resultsillustrated in FIG. 6b show that wasting disease in Rag^(−/−)animalsfollows transfer of CD4⁺CD45Rb^(high) cells and colonization with H.hepaticus (FIG. 6b ; PBS+Hh). These animals also develop intestinalpathology and express pro-inflammatory cytokines (as described above).Oral administration of PSA from the outset completely protects animalsagainst H. hepaticus-mediated wasting disease (PSA+Hh). H. hepaticusprovides the necessary antigens for inflammation induction; no pathologyis observed in uncolonized animals (PBS−Hh) or in animals without celltransfer. Therefore these experiments show that oral administration ofPSA protects animals against wasting (PSA+Hh).

In a further set of experiments, histologic sections of colons ofwild-type animals and animals subjected to transfer of CD4⁺CD45Rb^(high)T cells and colonization with H hepaticus (PBS+Hh) were examined toverify the presence of inflammation resulting in experimental colitis.The results illustrated in FIG. 6c show that transfer ofCD4⁺CD45Rb^(high) T cells into Helicobacter-colonized Rag^(−/−) miceresults in onset of severe colitis, as evidenced by massive epithelialcell hyperplasia and gross thickening of the gut wall (FIG. 6c ; secondpanel). Furthermore, consistent with previous studies, the combinationof CD4⁺CD45Rb^(high) T cell transfer plus H. hepaticus colonizationresults in infiltration of affected tissues by leukocytes—a hallmark ofinflammation and disease (FIG. 6c second panel bottom)^(19, 21).Additionally, oral administration of PSA to H. hepaticus-colonized celltransfer recipients confers complete protection against experimentallyinduced colonic hyperplasia (FIG. 6c ; third panel); furthermore,PSA-treated animals display no leukocyte infiltration in colonic tissues(FIG. 6c third panel, bottom)—a result indicating protection againstinflammation.

Taken together, these results indicate that oral administration of PSAprevents colitis and protects mice against the associated weight lossand inflammatory cell infiltration observed in diseased animals.

Example 9 PSA is Effective in Systemic Immune Compartments SuppressingCytokine Production by Th1 and Th17 Cells

In further series of experiments, mice were treated with TNBS orTNB/PSA, orally administered to the mice. The relevant colonic sectionswere subsequently analyzed by a blinded pathologist who provided ahistological score. The results illustrated in FIG. 14a provide furtherevidence that oral PSA administration reduces colitis.

While oral treatment with purified PSA protects from experimentalcolitis (FIG. 14a ), colonization by a B. fragilis mutant that does notmake PSA (B. fragilisΔPSA) is unable to protect. During the course ofthe experiments exemplified in Examples 1 to 8, Applicants noted strongeffects of PSA in systemic immune compartments. To further understandthese systemic responses Applicants utilized the TNBS induced model inthe susceptible Balb/c mouse strain. As this model allows for diseaseinduction in an immune-competent animal, it permits analysis of allimmune cells involved in both disease induction and protection.

Balb/c mice were orally administered purified PSA before induction ofcolitis. Indeed, oral treatment of PSA protected from weight lossassociated with experimental colitis and inflammation within theintestine (not shown).

Additionally, pre-treatment of Balb/c mice undergoing TNBS inducedcolitis, with PSA dramatically increases the survival of animals withdisease from 40% to 90%, (see FIG. 14b ), further attesting to thepowerful anti-inflammatory effects of PSA. Since splenomegaly iscommonly seen in this model of IBD and demonstrates the systemic natureof this disease, the Applicants analyzed the spleen of mice treated withTNBS, and TNBS/PSA. The results illustrated in FIG. 14c show that oraladministration of ZPS is protects from the splenomegaly. Furthermore,analysis of cytokine expression showed that animals undergoing TNBSinduced colitis have severe splenomegaly with increases in theexpression of inflammatory cytokines from CD4+T lymphocytes residingwithin the spleen, as illustrated in FIG. 14d . Orally administered PSAsignificantly reduces splenomegaly and the expression of TNF-α, IL-17and IL-21 in CD4+ T lymphocytes from the spleen during mucosal disease(FIG. 14d ). The experiments outlined in Example 5 demonstrate that PSAis able to protect from colitis through induction of IL-10 from CD4+ Tcells residing within the intestinal compartments. Consistent withprevious data, Applicants find that IL-10 levels are elevated within theCD4+ T lymphocytes in spleen (FIG. 14d ). Taken together, these datasuggest that PSA residing within the intestine is capable of effectingsystemic immunity. In particular these results show that oraladministration of ZPS can not only protect from intestinal disease butalso suppresses inflammation within extra-intestinal immunecompartments, such as the spleen.

Example 10 Parenteral Administration of PSA Protects from Inflammationand Controls TNF-a, IL-17 and IL23 Production in Intestine and Spleen

Distinct subsets of cells reside within the intestinal compartment,including CD8αα T cells, mucosal γδ T cells and CD103+ dendritic cells.Recent studies have demonstrated that these various cell types havedistinct functions from their systemic immune counterparts. To determinewhether PSA acts specifically within the intestine, purified PSA wasadministered intravenously and mucosal inflammation was induced. In afirst series of experiments illustrated in FIG. 15, PSA was administeredbefore inflammation was induced. In a second series of experiments,illustrated in FIG. 16, PSA was administered after inflammation wasinduced.

The results illustrated in FIG. 15, show that delivery of ZPS toextra-intestinal sites is able to protect from induced intestinalcolitis. In particular, systemic administration of PSA enhances thesurvival of diseased animals and protects from splenomegaly (60%survival vs. 90%) (FIGS. 15a and 15b ). Additionally, it is expectedthat colons of animals that treated with PSA systemically, havesignificantly less hyperplasia and inflammatory infiltrate.

The results illustrated in FIG. 16 show that while disease isexacerbated by the increased production of inflammatory cytokines at thesite of induction, systemic administration of PSA during TNBS inducedcolitis suppresses inflammatory cytokines at both intestinal andsystemic immune compartments. In particular,. TNF-α from MesentericLymph Nodes (MLN) CD4+ T cells is increased in expression during TNBSinduced colitis, but is reduced by PSA systemically administered (FIG.16a ). Additionally, inflammatory cytokines IL12p35 IL-23p19 and IL-17are elevated in the colons of diseased mice, as shown by analysis oftranscripts from RNA extracted from colons of mice undergoing TNBSinduced colitis, but are reduced by administration of PSA (FIG. 16b ).Also in spleen, systemic administration of ZPS reduces the production ofTNF-a from CD4+ T lymphocytes within the spleen as shown by the resultsillustrated in FIG. 16c . Furthermore, systemic administration of ZPSreduces expression of the transcripts IL-17, and IL-6 within the spleenas shown by the results illustrated in FIG. 16 d.

Additional experiments also demonstrated that while PSA decreasesexpression of inflammatory cytokines, intravenous treatment with PSAleads to an elevation in the production of IL-10 within the intestine(supplementary data). These data indicate that systemically administeredPSA is capable of extending to mucosal sites and protecting frominflammatory bowel disease.

The data illustrated in this example also show that systemicadministration of PSA during TNBS induced colitis suppressesinflammatory cytokines at both intestinal and systemic immunecompartments.

Example 11 Parenteral Administration of PSA Modulates CytokineExpression and Protects from Systemic Inflammation Caused by Th1 andTh17 Cells

Endotoxic shock occurs during severe gram-negative bacterial infectionsand is characterized by hypotension, multi-organ failure and potentiallydeath. This syndrome results from the production of multipleinflammatory cytokines, including TNF-a and IL-6, in response to thelipopolysaccharides (LPS) found in the cell wall of gram negativebacteria. IL-10 has been demonstrated to be a central regulator of theinflammatory response to LPS, indeed a single dose of IL-10 preventsdeath in murine models of endotoxic shock⁴². The dramatic effects of PSAwithin the systemic immune compartments lead us to investigate whetherPSA could ameliorate systemic inflammation.

To determine whether PSA was capable of suppressing inflammationassociated with endotoxic shock Applicants injected Balb/c mice with alow dose (100 ug) of LPS and monitored serum levels of the cytokinesTNF-α and IL-6. In particular, serum was collected from mice 1 and 4hours post-administration of 100 μg or 500 μg of LPS and TNF-α and IL-6protein levels in the serum were determined by ELISA.

The results illustrated in FIG. 17a to c , show that untreated mice hadundetectable levels of serum TNF-a and IL-6 at both time pointscollected. In particular, consistent with previous studies, in absenceof PSA administration, LPS treated mice experienced an over 300 foldincrease in serum TNF-α levels that peaked at one hour post injectionand decreased to basal levels by four hours post injection (FIG. 17a ).In absence of PSA treatment, also IL-6 levels in the serum of LPSinjected mice was detectable as early as 1 hour and continues toincrease in expression by 4 hours, (FIG. 17b ). Remarkably, mice thathad been pre-treated with PSA had a significant reduction in serumlevels of TNF-α and IL-6 at both time points (FIGS. 17a and 17b ),indicating that PSA is able to prevent the early induction ofinflammatory cytokines in response to LPS.). Additionally, in absence ofPSA treatment, splenomegaly occurs within three days of LPS injectionand results from the recruitment of inflammatory cell types. Animalspre-treated with PSA, have smaller spleens and express lower levels ofinflammatory cytokines at this site (data not shown and FIG. 17c ).

This data demonstrates that PSA is capable of suppressing systemicinflammatory responses induced by a low dose administration of LPS.

Example 12 Parenteral Administration of PSA Results in TNF-a Modulationand Treatment Systemic Inflammation

Death occurring during endotoxic shock is a result of the elevatedlevels of inflammatory cytokines that occur within hours of the responseto LPS. Indeed, blockage of the inflammatory mediator TNF-α completelyrescues animals from LPS induced mortality. That PSA had such a dramaticeffect on the levels of the cytokines expressed during low doseadministration of LPS, suggested that PSA might prevent death associatedwith endotoxic shock. Applicants therefore administered high dose levelsof LPS (500 that cause death with 24-96 hours and accessed both cytokinelevels within the serum and monitored survival.

The results illustrated in FIGS. 17d and 17e , show that while animalsthat were administered PBS all die within 60 hours of administration ofLPS, those animals that received PSA treatment have a significantlyincreased survival rate (FIG. 17d ). Remarkably, while PBS animals havean over 3000 fold induction of TNF-a when administered LPS, those micereceiving PSA have very little TNF-α induction (FIG. 17e ). These datademonstrate that PSA is able to suppress the systemic inflammatoryresponse that ensues in response to LPS and is able to protect fromseptic shock.

As shown in the exemplary experiments of Example 7 PSA mediatedprotection from IBD is reliant on IL-10 production from a CD4+ Tlymphocyte. To determine whether IL-10 is required for protection fromLPS induced death Applicants pretreated IL10 deficient animals with PBSor purified PSA and administer levels of LPS that would result in septicshock. The cytokine level and percentage survival were monitored.

The results illustrated in FIG. 18, show that consistent with previousdata IL10-deficient animals were more sensitive to lower doses of LPSand TNF alpha levels continue increase (FIG. 18a ). Interestingly, PSAtreated animals have a drastic decrease in the levels of serum TNF-a inresponse to LPS that drops to negligible levels by 4 hours post LPSadministration (FIG. 18a ), indicating that decreased TNF-a levels byPSA is not dependent on the ability of PSA to induce IL-10. Strikingly,decreased IL-6 production by PSA is IL-10 dependent as levels aresimilar to PBS treated animals, indicating multiple mechanisms areemployed by PSA to alleviate endotoxic shock (FIG. 18b ). Finally, IL10deficient mice receiving PSA are completely protected from LPS induceddeath (FIG. 18c ).

Additional experiments were performed to detect additional effects ofPSA administration in connection with low dose LPS administration inmice. The results illustrated in FIG. 19 show that other effects of ZPSadministration during low dose LPS administration include a reduction inCD11 b and GR1 expression on the surface of neutrophils as well asreduced neutrophil recruitment in the blood.

Taken together, the data of this example and of example indicate thatPSA is capable of blocking extra-intestinal disease and is expected tobe a novel therapeutic agent to reduce systemic inflammation.

Example 13 PSA Increases Survival of Mice with Induced Colitis whenGiven Before or after Disease Induction

A first group of 8 week old Balb/c mice were orally gavaged with 50 μgof purified PSA three times every other day prior to colitis inductionby rectal administration of 100 mg of 1.25% TNBS in 50% ethanol andevery other day throughout the course of disease. A second group of 8week old Balb/c mice were orally gavaged with 50 μg of PSA 24 hourspost-colitis induction performed by rectal administration of 100 ml of1.25% TNBS in 50% ethanol and every other day throughout the course ofdisease. Control mice were rectally administered 50% ethanol as avehicle control. Each group had 6-11 mice.

The percent survival was determined for each treatment and isillustrated in the diagram of FIG. 20. The diagram of FIG. 20 shows thatonly 45% of mice survive when treated with PBS alone (red square) while100% of mice survive when pretreated with PSA and over 90% of micesurvive when PSA is given as a treatment for disease, demonstrating thatPSA can enhance the survival of mice even when disease has alreadybegun.

Example 14 PSA can Prevent Disease Associated Weight Loss when GivenBefore or after Disease Induction

Balb/c mice were treated as described in Example 13 and were weighed onthe day of TNBS induction (day 0) and every day thereafter at the sametime of day.

The percentage variations in weight associated with the varioustreatments is illustrated in the diagram of FIG. 21 which furtherconfirms that PSA can prevent disease associated weight loss when givenbefore or after the induction. In particular, while, PBS treated-withTNBS induction (FIG. 21, squares)—showed a significant weight loss withrespect to vehicle treated mice, with no induced TNBS (FIG. 21diamonds)—, PSA treatment prior to TNBS induction (FIG. 21 triangles)and, PSA treatment after TNBS induction (FIG. 21 circles)significantlyreduce the weight loss.

These results further confirm PSA ability to prevent and cure a diseaseassociated with an imbalanced Th cell profile.

Example 15 PSA Administration Results in Treatment or Prevention ofExperimental Colitis

Balb/c mice were treated as described in Example 13. Colons from micewere extracted 4 days post-TNBS induction and fixed in paraformaldehydeand embedded in paraffin. Sections of the colon were stained with H&Eand examined by a blinded pathologist (Dr. Greg Lawson-University ofCalif., Los Angeles) for signs of intestinal inflammation includedepithelial hyperplasia, lymphocyte infiltration, and mucosal thickening.

Increased colitis scores shown in the illustration of FIG. 22, indicateincreasing severity of disease, thus further showing that PSA is able toprevent or treat on-going experimental intestinal inflammation. p valueswere calculated using a students t test.

Hence these results further confirm PSA ability to prevent and cure adisease associated with an imbalanced Th cell profile.

Example 16 PSA Administration Post-Disease Induction Increases thePercentage of Treg Cells in the Mesenteric Lymph Nodes

In previous experiments, it was shown that PSA can increase the numberand percentage of Treg cells when given to mice before disease onset.Here a further series of experiments confirm that PSA can increase thepercentage of Tregs cells within the MLNs when given to mice alreadysuffering from disease, suggesting that the mechanism by which PSA canprevent or cure experimental colitis is through the expansion of asuppressive population of T cells.

MLNs were extracted from mice treated as described in Example 13. Cellswere stained for CD4, CD25 and Foxp3 (as a marker of Treg cells).

The results illustrated in the diagram of FIG. 23 further confirm thatPSA can prevent disease associated weight loss when given after theinduction PSA administration post-disease induction increases thepercentage of Treg cells in the mesenteric lymph nodes.

Example 17 PSA Promotes Inducible Foxp3+ Tregs with Suppressive ActivityTowards Inflammatory Responses

PSA was orally administered to mice and the CD4+ CD25+Foxp3+ populationof Tregs in the MLN was monitored. Mice treated with PSA displayedincreased percentages of CD4+ Foxp3+ T cells compared to control mice(FIG. 24A). One of the primary functions of Treg cells is to suppressthe activation and proliferation of inflammatory effector T cells. Thesuppressive properties of Tregs following PSA administration weredetermined by the addition of varying ratios of CD4+CD25+ T cellspurified from MLNs to naïve responder cells. Tregs isolated fromPSA-treated animals have increased suppressive capacity compared toPBS-treated control animals (28.5% proliferating responder cells vs.43.0% at a 1:2 Treg:Teff ratio) (FIG. 24B). These findings demonstratethat PSA induces the differentiation of functional Foxp3+ Tregs withenhanced suppressive activity.

Various subsets of Tregs exist within the Foxp3+ and Foxp3− T cellpopulations; therefore, the expression of Treg-associated genes wasanalyzed to understand how PSA affects the development of Foxp3+ Tregs.Foxp3−GFP mice were gavaged with purified PSA (or PBS control), and RNAwas extracted from either CD4+Foxp3− or CD4+Foxp3+ T cells from the MLNsfollowing cell purification. As expected, gene expression in Foxp3− andFoxp3+ T cell subsets differed dramatically and included higher basallevels of IL-10, TGF-β2, GITR, ICOS, CTLA-4 and Ebi3 (subunit of IL-35)in Foxp3+ T cells (FIG. 24,C and FIG. 25). Remarkably, PSA induces over8-fold increased levels of IL-10 from CD4+Foxp3+ Tregs than thatexpressed in PBS-treated cells, and had virtually no impact onCD4+Foxp3− T cells. Accordingly, while TGF-β2 expression in CD4+Foxp3− Tcells was not altered, PSA elicited significant induction of TGF-β2 fromFoxp3+ Treg cells. Though Treg subsets that do not express Foxp3 havebeen described based on IL-10 and TGFβ production (Tr1 and Th3 cells,respectively)⁴⁴, PSA's effects are restricted to the Foxp3+ Tregpopulation. PSA treatment also significantly increases the transcriptionof granzyme B, perforin and CCR6 (a chemokine receptor associated withthe migration of Treg cells) from Foxp3+ Tregs (FIG. 24C and FIG. 25).It is important to note that PSA does not globally impact allTreg-derived cytokines, as expression of TGF-β1 and Ebi3 are notaltered, demonstrating specificity for a distinct Treg profile.Furthermore, production of the natural Treg-associated surface receptorsCTLA-4, GITR, and ICOS are not changed among Foxp3+ cells in response toPSA treatment (FIG. 24C and FIG. 25). Taken together, these data revealthat PSA activates inducible Foxp3+ Tregs and identifies a‘PSA-specific’ gene expression program within Foxp3+ Treg cells.

Colonization of germ-free animals with PSA-producing bacteria waspreviously reported to be able to induce production of the Th1 cytokineinterferon-γ (IFNγ) among splenic CD4+ T cells⁴⁰. To further investigatethe lineage differentiation of immune cells directed by PSA, we examinedanimals for IFNγ expression among Foxp3+ T cells. Intriguingly, IFNγexpression in the MLNs is found exclusively in the Foxp3− subset and isnot affected by microbial colonization (FIG. 26). Furthermore, splenicCD4+ T cells produce IFNγ only from Foxp3−/IL-10-T cells that isdependent on PSA expression (FIG. 27). These results demonstrate thatthere is a compartmental difference in the ability of PSA to induce aTh1 profile in the spleen, while promoting a tolerogenic immuneenvironment in the gut consisting of CD4+Foxp3+IFNγ-Treg cells.

Example 18 PSA Expands Functional Foxp3+ Tregs During Protection fromExperimental Colitis

Intestinal inflammatory activation of innate and adaptive immune cellsand secretion of inflammatory cytokines were not found under steadystate conditions. Foxp3+ Treg cell development was then examined duringintestinal disease induced by TNBS. TNBS (2,4,6-trinitrobenzene sulfonicacid) treatment of animals results in gut inflammation which activates Tcell responses; animals lose a significant amount of weight, displaymarked thickening of the colon, with lymphocyte infiltration andconcomitant epithelial hyperplasia⁴⁵.

The results of these experiments are illustrated in FIGS. 28 to 30. Aspreviously reported, disease was not evident in TNBS-treated animalsthat were treated with purified PSA⁴³. Vehicle treated (PBS; -TNBS) andPBS treated TNBS animals (TNBS+PBS) had a similar percentage of Foxp3+Treg cells within the CD4+CD25+ T cells of the MLN (FIG. 28A).Consistent with PSA's anti-inflammatory properties, mice given PSAreproducibly had a 5-10% increase in the percentage of Foxp3+ cellswithin the CD4+CD25+ compartment of the MLNs (FIG. 28A). Additionally,the absolute number of CD4+CD25+Foxp3+ cells in the MLNs wassignificantly higher in PSA-treated mice when compared to PBS ornon-colitic animals (FIG. 28B). PSA expansion of the Foxp3+ Tregpopulation is specific, as the percentage of B cells in the MLNs did notdiffer between PBS and PSA fed mice (FIG. 29).

Consistent with an increase in the percentage of Foxp3+ cells in PSAtreated mice, there was an increase in the expression of the foxp3transcript in MLNs (FIG. 28C). Furthermore, we also found that the Foxp3expression was increased on a per cell basis in CD4+CD25+ cells duringPSA-mediated protection from colitis (FIG. 30), demonstrating that PSAup-regulates proportional and cell-intrinsic Foxp3 expression. Thesuppressive capacity of Tregs during PSA-mediated protection fromintestinal inflammation was determined by in vitro suppression assays.

As expected, proliferation was partially suppressed (proliferation ofeffector cells in the absence of Tregs was >than 90%) when Tregs fromvehicle (PBS; -TNBS) or PBS-treated colitic mice (TNBS+PBS) were addedto the culture (FIG. 28D). Notably however, Tregs isolated from the MLNsof PSA fed mice (TNBS+PSA) suppressed T cell proliferation to asignificantly higher level than cells from untreated animals (43.5%proliferating responder cells vs. 63.5% at a 1:2 Treg:Teff ratio),demonstrating Tregs from animals protected from colitis by PSA haveincreased functional suppressive activity.

Example 19 PSA Treatment Cures Animals with Experimental Colitis

In various situations prophylactic therapies for IBD are unsuitable asthere are no diagnostics that accurately predict disease development,and patients must be treated after onset of symptoms. The possibilitythat PSA could be efficacious for established colitis, potentiating itsapplication as a treatment for established IBD was thereforeinvestigated.

Animals were induced for TNBS colitis, and groups were treated with PBSprior to disease induction (TNBS+PBS) or PSA, either prior to diseaseinduction (pre-TNBS+PSA) or following rectal TNBS administration(post-TNBS+PSA). PBS treated TNBS animals lost a significant amount ofweight (approx. 20% weight loss) by 8 days (FIG. 31A).

PSA treatment 1 day following onset of intestinal inflammation correctedweight loss equal to or better than PSA treatment prior to disease;treatment 2 days after colitis induction also provided protection (FIG.32). Animals with colitis exhibited severe disease 5 days post-TNBStreatment which was not seen in animals treated with PSA post-TNBS (FIG.31B).

Using a standard scoring system, animals treated with TNBS showed a highdegree of disease (FIG. 31C). However, both pre- and post-treatment withPSA significantly prevented the development of colitis similarly.Animals administered PSA following the onset of disease showed increasedIL-10 and Foxp3 expression in gut tissues (FIG. 32), and displayed asignificant decrease in IL-17 levels during both protection and cure ofcolitis (FIG. 33). Accordingly, the percentage of CD4+CD25+Foxp3+ subsetwas significantly increased in PSA-treated animals compared to diseasedanimals (FIG. 31D). Rectal administration of high doses of TNBS causes asevere intestinal immune response that leads to mortality of animals.Remarkably, animals treated with PSA, even after the commencement ofdisease, were dramatically rescued from death compared to controltreated animals (FIG. 31E).

Together our studies reveal that gut bacteria produce molecules thatcoordinate the development of inducible Foxp3+ Tregs, andimmunomodulation of Tregs by PSA can represent a novel approach toengendering mucosal tolerance as a therapy for intestinal inflammatorydiseases.

Example 20 PSA Treatment Cures Animals Suffering from Endotoxic Shock

High doses of LPS (500 μg) were administered i.p. to Balb/c mice. 10 or30 minutes post LPS administration, PSA was given retro-orbitally. 1hour post-LPS, serum was collected and levels of Il-6 (FIG. 34) andTNF-α (FIG. 35) were determined. FIGS. 34 and 35 demonstrate that PSAcan reduce inflammatory cytokines when administered after the systemicinflammatory stimulus (LPS) suggesting that PSA could be a therapy forendotoxic shock.

Example 21 PSA Treatment Cures Animals with Endotoxic Shock

The results illustrated in FIG. 36 indicate that PSA can increasesurvival of mice already suffering from endotoxic shock. Mice were given500 ug of LPS via i.p. injection. Animals were administered PSAsystemically (retroorbital injection) 10 and 30 minutes after theadministration of LPS. Survival of animals was determined.

The examples set forth above are provided to give those of ordinaryskill in the art a complete disclosure and description of how to makeand use the embodiments of the compounds compositions and methods of thedisclosure, and are not intended to limit the scope of what theinventors regard as their disclosure. Modifications of theabove-described modes for carrying out the disclosure that are obviousto persons of skill in the art are intended to be within the scope ofthe following claims. All patents and publications mentioned in thespecification are indicative of the levels of skill of those skilled inthe art to which the disclosure pertains. All references cited in thisdisclosure are incorporated by reference to the same extent as if eachreference had been incorporated by reference in its entiretyindividually.

The entire disclosure of each document cited (including patents, patentapplications, journal articles, abstracts, laboratory manuals, books, orother disclosures) in the Background, Summary, Detailed Description, andExamples is hereby incorporated herein by reference.

Further, the hard copy of the sequence listing and the correspondingcomputer readable form submitted herewith are both incorporated hereinby reference in their entireties.

It is to be understood that the disclosures are not limited toparticular compositions or biological systems, which can, of course,vary. It is also to be understood that the terminology used herein isfor the purpose of describing particular embodiments only, and is notintended to be limiting. As used in this specification and the appendedclaims, the singular forms “a,” “an,” and “the” include plural referentsunless the content clearly dictates otherwise. The term “plurality”includes two or more referents unless the content clearly dictatesotherwise. Unless defined otherwise, all technical and scientific termsused herein have the same meaning as commonly understood by one ofordinary skill in the art to which the disclosure pertains.

Although any methods and materials similar or equivalent to thosedescribed herein can be used in the practice for testing of the specificexamples of appropriate materials and methods are described herein.

A number of embodiments of the disclosure have been described.Nevertheless, it will be understood that various modifications may bemade without departing from the spirit and scope of the presentdisclosure. Accordingly, other embodiments are within the scope of thefollowing claims.

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1.-6. (canceled)
 7. An anti-inflammatory pharmaceutical compositioncomprising: a zwitterionic polysaccharide in an amount of from about0.01 μg to about 1000 μq; and a pharmaceutically acceptable vehicle. 8.The anti-inflammatory composition of claim 7, wherein the zwitterionicpolysaccharide amount is between about 1 μg and about 100 μg.
 9. Theanti-inflammatory composition of claim 7, wherein the zwitterionicpolysaccharide is a B fragilis capsular polysaccharide A (PSA) orpolysaccharide B (PSB).
 10. A method for treating a condition associatedwith a cytokine mediated inflammation in an individual the cytokinebeing at least one of IL-1, IL-6, TNF-α, IL-17, IL-21 and IL-23, themethod comprising orally or parenterally administering to the individualan amount of a purified zwitterionic polysaccharide effective to treatinflammatory bowel disease, dermatitis, arthritis, myasthenia gravis,Grave's disease, sclerosis, endotoxic shock or psoriasis.
 11. The methodof claim 10, wherein the cytokine is IL-17.
 12. The method of claim 10,wherein the zwitterionic polysaccharide is a B. fragilis capsularpolysaccharide A (PSA).
 13. The method of claim 10, wherein theinflammatory bowel disease is Crohn's disease and/or ulcerative colitis.14. A method for treating a condition associated with an imbalancedT-helper cell profile, the T-helper cell profile being at least one ofTh17, the method comprising orally or parenterally administering to theindividual a pharmaceutical composition comprising a purifiedzwitterionic polysaccharide in an effective amount to treat rheumatoidarthritis, allograft rejection, systemic lupus erythematosus,tumorgenesis, multiple sclerosis, systemic sclerosis and chronicinflammatory bowel disease.
 15. The method of claim 14, wherein theT-helper cell profile is a Th17 cell profile.